A joint conference with MAPA and PANE 2009 Ophthalmic Pathology Emiko Furusato, M.D. Department of Neuropathology and Ophthalmic Pathology Armed Forces Institute of Pathology Contents
Grossing the globe Ocular histology 10 Representative cases Grossing the ocular specimen Four basic steps 1. 2. 3.
4. Orient the specimen and determine laterality Measurements Transillumination (TI) Sectioning the globe Grossing the ocular specimen 1. Orient the specimen and determine laterality
Anatomic landmarks that orient the specimen Cornea: Horizontal meridian is wider Long posterior ciliary vessels: Blue line marks horizontal meridian posteriorly Inferior oblique: Inferotemporal quadrant, nasal end near fovea, no tendon Superior oblique: Superiorly and temporally, shiny tendinous insertion
Superior oblique muscle Long ciliary vessel Optic nerve Temporal side Nasal side
Inferior oblique muscle Vortex vein Posterior aspect of left eye Superior oblique muscle Optic nerve
Nasal Nasal sideside Temporal side Inferior oblique muscle Long ciliary vessels
Posterior aspect of right eye Horizontal diameter :11 mm Nasal side Temporal side Vertical diameter: 10mm
Anterior aspect of right eye Grossing the ocular specimen 2. Measurements Globe: AP (antero-posterior including the cornea), Horizontal, Vertical, length of the optic nerve Normal eye (24 mm = one inch) in diameter
Cornea: Horizontal and vertical planes 12 (horizontal) x11mm (vertical) or 11X10mm. Diameter of pupil Note dimensions of any lesions such as wounds, tumors, etc Grossing the ocular specimen 3.Transillumination (TI)
Grossing the ocular specimen 3.Transillumination (TI) Transilluminated prior to dissection. Use dissecting microscope illuminator in a darkened room. Applications Uveal malignant melanoma Dark shadow on the sclera
Dark band of ciliary body Pupil Pigmented tumor show round shadow Ciliochroidal melanoma Lens
Ciliary body Optic nerve Retinal detachment Grossing the ocular specimen 4.Sectioning for the globe Pupillary Optic nerve (PO) section
Optic nerve Superior calotte Inferior calotte Initial cut: Cornea side down
Grossing the ocular specimen 4.Sectioning the globe Inferior calotte Second cut: Cut surface down Grossing the ocular specimen 4.Sectioning the globe
the overlying thick basemembrane Posterior: No epithelium therefore, remains thinner than anterior capsule Lens cortex and nucleus Layers of lens cells (fibers) that become compressed as they move inward
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