discs.» Part of blood-retinal barrier. The damage of increased intra- ocular pressure (aka glaucoma) manifests in the retina, not the anterior structures of the eye. Ophthalmic pathology is a laboratory-based discipline which provides an essential service to ophthalmologists and related professionals by examining samples. An elementary textbook of ophthalmic pathology must bridge two seemingly Download the PDF to view the article, as well as its associated figures and tables.
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This outstanding atlas of ophthalmic pathology brings together the world famous collection of digital images from the Tennant Eye Institute in. Crash Course in. Ophthalmic Pathology. Morton E. Smith, MD. Professor Emeritus. Associate Dean Emeritus. Washington University in St. Louis. BMA Medical Book Awards Highly Commended in Pathology Category! Comprehensive, yet concise and clinically oriented, the new edition of Ocular.
The cyanotic category included lesions with right-to-left shunts or mixing abnormalities transposition of the great vessels, persistent truncus arteriosus, tetralogy of Fallot. The obstructive category included pulmonary valve stenosis, aortic valve stenosis, and coarctation of the aorta. Results In all, subjects were examined.
Gender distribution was Physiologically, the cardiac categories included volume overload in 90 The most common anatomic cardiac anomalies were ventricular or atrial septal defects 62 , tetralogy of Fallot 39 , pulmonary stenosis 25 , and transposition of the great arteries Other lesions included patent ductus arteriosus 13 , double-outlet right ventricle 11 , aortic stenosis 10 , pulmonary atresia 10 , coarctation of aorta 9 , single ventricle 6 , and atrio-ventricular canal 6.
Hypoxia occurred in A total of 81 subjects had undergone some type of surgical intervention prior to the eye exam. In all, subjects The paediatric team recognized 51 syndromic patients, and the two geneticists identified the additional 54 syndromic patients.
Cataract, ptosis, and strabismus occurred mainly in the syndromic population: eleven of twelve patients with ptosis, nine of eleven patients with strabismus, and five of six patients with cataract were syndromic Table 1. High myopia more than eight , high hyperopia more than 6 , and high astigmatism more than 2 were present in four, six and 11 subjects, respectively. The mean astigmatism was 0. Retinal vascular tortuosity was present in 11 subjects with the velocardiofacial syndrome: five of 11 had normal hematocrit and oxygen saturation.
There was no relation between hyperopia and either retinal vascular tortuosity or optic nerve hypoplasia. In all, 10 subjects had both retinal vascular tortuosity and optic nerve hypoplasia See Figures 1 and 2. Figure 1 Posterior pole of right eye. Retinal artery tortuosity and optic nerve hypoplasia in a year-old male subject with pulmonic stenosis, aortic stenosis, and Williams syndrome. Full size image Figure 2 Posterior pole of left eye.
Full size image There was a correlation between the CHD anatomic types and syndromes. There was no correlation between the CHD anatomic types and eye findings.
The incidence of CHD in the medical centre was retrospectively 1. There are several studies on the prevalence of individual chromosomal abnormalities, like 22q Borgmann et al 31 found that routine screening for 22q The morphological identification by geneticists is thereby emphasized.
The large percentage of ocular findings in CHD could be related to the high incidence of associated syndromes Tables 1 and 2 , to the possible embryologic link between the ocular and cardiac defect, or to the high incidence of consanguinity.
The present cross-sectional study underestimates the incidence of strabismus as half of the subjects were examined below age one. The present study did not measure intraocular pressure that can be elevated in some subjects with congestive heart failure.
Petersen and Rosenthal 5 found dilation and tortuosity of retinal vessels to be related to hypoxia and polycythaemia and to be present in nearly half of the patients 42 of 83 with cyanotic CHD. Analysis of our data suggests that subjects with high or low haematocrit develop tortuosity. In patients with normal haematocrit, low oxygen saturation or the presence of the velocardiofacial syndrome may account for the tortuosity. Since there is a very high incidence of smoking in Lebanon, 36 and a large number of patients were examined soon after birth, the effect of smoking mothers on the high incidence of retinal vascular tortuosity in neonates is to be considered.
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