Ocular curiosities!

‘Ocular curiosities!’⁣

Vitreous Cysts⁣

Tansley, 1899 - irregular spherical cyst that showed lines of pigment on its surface⁣

Congenital Cysts⁣

Remnants of the hyaloid vascular system⁣

Located at hyaloid canal & found in conjunction with Mittendorf's dot or⁣

Bergmeister's papillae⁣

Stable, do not progress and rarely interfere with vision⁣

Non-pigmented pearl-gray cysts with a smooth surface, sessile or pedunculated⁣

Located anterior to optic disc⁣

Can be limited in movement due to vitreous strands attaching cyst to optic⁣

disc⁣

Acquired Cysts⁣

Ocular trauma⁣

Intraocular inflammation/infection/ uveitis eg. Intermediate Uveitis, Toxoplasmosis⁣

Retinal diseases such as Retinitis pigmentosa, Choroidal atrophy, Retinoschisis, High myopia with uveal coloboma etc⁣

Retinal detachment surgeries⁣

Usually symptomatic -reduced vision⁣




Types⁣

Pigmented⁣

From pigment epithelium of iris or ciliary body later become detached into the vitreous, Brown colour⁣

Non-Pigmented⁣

From hyaloidal vascular system⁣

Translucent, mobile, yellow-gray⁣

HPE⁣

Congenital cysts are choristomas of primary hyaloidal system⁣

Derived from pigment epithelium of iris or ciliary body⁣

Contains immature melanosomes⁣

Pathophysiology of Acquired Cysts⁣

Trauma can cause damage to pigment epithelium of ciliary body and create pigment cysts⁣

Other theories: Vitreous reaction to underlying retinal degeneration can causes cysts, Ciliary adenoma breaking into the vitreous, cystic growths that occur at site of coloboma that enter the vitreous⁣

DD:⁣

Pigmented cysts mimic pigmented ocular tumors such as malignant melanoma Nonpigmented cysts mimic parasitic cysts such as Cysticercosis, Echinococcus etc.⁣

Ocular Investigations:⁣

B Scan to look for scolex in case of cysticercosis⁣

OCT - characterize the cyst⁣

UBM - rule out anomalies of ciliary body or posterior iris⁣

FFA - characterization of intra and extra cystic vascularisation ⁣

Management⁣

Asymptomatic cysts⁣

Observation and follow-up ⁣

Symptomatic cysts⁣

Laser cystotomy by Argon laser/Nd:Yag laser⁣

Pars plana vitrectomy with cyst excision⁣


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Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident

Link to article: https://eyewiki.aao.org/Vitreous_Cysts⁣

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