Recurrent vitreous hemorrhage secondary to haptic-induced chafing

CASE REPORT

After cataract extraction and placement of a posterior chamber intraocular lens, a 70-year-old man had 5 vitreous hemorrhages over 3 years. Iris transillumination defects and apposition of the nasal haptic and ciliary body were found.

COMMENTS

Iris chafing is a rare complication of cataract extraction. Vitreous hemorrhage presumably resulted from iris erosion caused by the IOL haptic.

Optical coherence tomography of enucleated human eye specimens with histological correlation: origin of the outer "red line"

PURPOSE

To further define the origin of the "outer red line" (ORL) present in retinal optical coherence tomograms.

DESIGN

Laboratory investigation.

METHODS

Eleven formalin-fixed caps of seven human eyes previously enucleated for choroidal melanoma at the Wilmer Eye Institute were studied. The ORL evaluation consisted of sequential, surgical elimination of the retinal pigment epithelium, Bruch's membrane (BM), and choroid in separate, but adjacent, areas. Optical coherence tomography (OCT) images through each of these areas were correlated with corresponding histologic sections. The relative contribution of the retinal pigment epithelium, BM, and choroid to the ORL in retinal OCT3 images was evaluated.

RESULTS

In the specimens examined, the ORL correlated anatomically with a highly reflective optical surface at the level of the outer retina, and did not appear to represent a specific anatomic layer. The reflecting layers appeared to be composed of the retinal pigment epithelium, BM, and inner choroid. The relative contribution of BM together with the inner choroid to the ORL appeared greater than that of the retinal pigment epithelium.

CONCLUSIONS

This study suggests that the ORL present in retinal OCT3 images and generally associated with the retinal pigment epithelium/BM/inner choroidal complex appears to indicate a highly reflective optical surface which, when eye layers are normally configured, represents this complex of anatomic structures with a predominant contribution from BM and inner choroid. The findings of this study suggest a potential role for OCT in the eye pathology laboratory.

Optical coherence tomography of peripheral retinal lesions in enucleated human eye specimens with histologic correlation

PURPOSE

To report optical coherence tomography (OCT) histologic correlations of three common peripheral retinal lesions and to explore the feasibility of the use of OCT to image retinal pathologic conditions in fixed tissue specimens.

DESIGN

Experimental study.

METHODS

We studied peripheral retinal lesions that were available to us in 11 formalin-fixed caps of seven human eyes that had been enucleated previously for choroidal melanoma. OCT scans were performed through these lesions, and the images were correlated with corresponding histologic sections.

RESULTS

Three peripheral retinal diseases that included cystoid degeneration, localized retinal detachment, and paving stone degeneration were imaged successfully, and their optical characteristics correlated well with their histologic data.

CONCLUSION

We explored potential utility for OCT imaging of peripheral retinal pathologic conditions in fixed tissue specimens. That these OCT images correlate with findings from histologic sections suggests a possible role for OCT in the eye pathology laboratory.

Extreme hyperopia is the result of null mutations in MFRP, which encodes a Frizzled-related protein

Nanophthalmos is a rare disorder of eye development characterized by extreme hyperopia (farsightedness), with refractive error in the range of +8.00 to +25.00 diopters. Because the cornea and lens are normal in size and shape, hyperopia occurs because insufficient growth along the visual axis places these lensing components too close to the retina. Nanophthalmic eyes show considerable thickening of both the choroidal vascular bed and scleral coat, which provide nutritive and structural support for the retina. Thickening of these tissues is a general feature of axial hyperopia, whereas the opposite occurs in myopia. We have mapped recessive nanophthalmos to a unique locus at 11q23.3 and identified four independent mutations in MFRP, a gene that is selectively expressed in the eye and encodes a protein with homology to Tolloid proteases and the Wnt-binding domain of the Frizzled transmembrane receptors. This gene is not critical for retinal function, as patients entirely lacking MFRP can still have good refraction-corrected vision, produce clinically normal electro-retinograms, and show only modest anomalies in the dark adaptation of photoreceptors. MFRP appears primarily devoted to regulating axial length of the eye. It remains to be determined whether natural variation in its activity plays a role in common refractive errors.