Moran CORE

Open source ophthalmology education for students, residents, fellows, healthcare workers, and clinicians. Produced by the Moran Eye Center in partnership with the Eccles Library

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Retina & RPE Histopathology

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Normal Retinal Anatomy

 
Color fundus photo of the retina

 
Histologic appearance of retinal layers

 
Retinal layers in the macula

 
Histologic appearance of the fovea

 
Oblique orientation of axons in outer plexiform layer forming Henle’s layer

Hypertensive Retinopathy

 
Fundus photo of hypertensive retinopathy

 
Silver-wiring from hypertensive retinopathy

 
Optic disc swelling from hypertensive retinopathy

Central Retinal Artery Occlusion (CRAO)

 
Fundus photo

 
Inner retina affected by CRAO

Branch Retinal Artery Occlusion (BRAO)

 
Fundus photo

Central Retinal Vein Occlusion (CRVO)

 
Cross-section of atherosclerotic central retinal artery

 
Fundus photo

 
Gross photo of sagittally cut globe

 
Retinal architecture disrupted from CRVO

Branch Retinal Vein Occlusion (BRVO)

 
Fundus photo

Diabetic Retinopathy

 
Trypsin-digest showing microaneurysms from loss of pericytes

 
Fundus photo of diabetic retinopathy

 
Fundus photo of hard exudates

 
Histopathology of hard exudates

 
Fundus photo of cotton-wool spots

 
Cotton-wool spots in Ganglion Cell and Nerve-fiber layers

 
Swollen ganglion cells in cotton-wool spot

 
Fundus photo of neovascularization elsewhere (NVE)

 
Neovascularization of the disc (NVD)

 
Scarring and hemorrhage from neovascularization

 
Boat-shaped, pre-retinal hemorrhage in proliferative diabetic retinopathy

 
Neovascularization of iris (NVI), also known as rubeosis iridis

 
Ectropion uveae from NVI

 
Neovascularization of the angle

 
Lacy vacuolization of iris pigment epithelium

 
PAS stain showing thickened basement membrane of ciliary body epithelium

 
Pan-retinal photocoagulation

 
Histopathology of PRP spots

Sickle Cell Retinopathy

 
Fluorescein angiogram of Sickle cell or Eales disease

 
Sickled RBCs in retinal vasculature

Macular Holes

 
Fundus photo of full-thickness macular hole

 
Magnified fundus photo of macular hole with fixation rod

 
Edge of macular hole showing edema

Epiretinal Membranes (ERM)

 
Fundus photo of epiretinal membrane

 
Fundus photo of epiretinal membrane

 
Red-free fundus photo of epiretinal membrane

 
OCT showing wrinkling of the macula

 
OCT of epiretinal membrane

 
Histology of epiretinal membrane

Dry Age-related Macular Degeneration

 
Fundus photo

 
Soft drusen

 
Large soft drusen

 
Fundus photo of confluent drusen around the fovea

 
Large, confluent soft drusen

 
Fundus photo of geographic atrophy

 
RPE atrophy in geographic atrophy

Wet Age-related Macular Degeneration

 
Sub-RPE and subretinal neovascularization

 
Larger sub-RPE and subretinal neovascularization

 
Histopathology of sub-RPE neovascularization
Photo reference: Harper RA. Basic Ophthalmology. Amer Academy of Ophthalmology; 2010.

Retinal Neovascularization

Gliosis

 
Disciform scar from neovascularization

Retinal Neovascularization

Cystoid Macular Edema

 
Fundus photo of cystoid macular edema (CME)

 
Autofluorescence of CME

 
Histopathology of CME in Henle’s layer

Bull’s Eye Maculopathy

 
Fundus photo of bull’s eye maculopathy

 
FA of bull’s eye maculopathy

Best Disease

 
Fundus photo

 
Sub-RPE deposit in Best disease

Stargardt Disease

 
Fundus photo

 
Hypertrophic RPE cells filled with lipofuscin-like material

Fundus Flavimaculatus

Pattern Dystrophy

Fungal Chorioretinitis

 
Presumed ocular histoplasmosis

Toxoplasmosis

 
Fundus photo of active toxoplasmosis

 
Chorioretinal scar in quiescent disease containing toxoplasma

 
Destruction of retina, RPE, and choroid form toxoplasmosis

CMV Retinitis

 
Fundus photo

 
Intracytoplasmic and intranuclear inclusions

Acute Retinal Necrosis (ARN)

Bacterial Chorioretinitis

Pseudoxanthoma Elasticum (PXE)

 
Angioid streaks in pseudoxanthoma elasticum

 
Flexural creases in pseudoxanthoma elasticum

Retinitis Pigmentosa

 
Fundus photo of classic triad of features in retinitis pigmentosa

 
Bony spicules

 
Histopathology of retinitis pigmentosa

Typical Peripheral Cystoid Degeneration (TPCD)

Reticular Degenerative Retinoschisis

Lattice Degeneration

Paving Stone Degeneration

Retinopathy of Prematurity (ROP)

 
External photo of bilateral leukocoria

 
Fundus photo of dragged disc in resolved ROP

 
Gross photo of exudative retinal detachment

 
Scleral buckle used in funnel retinal detachment

Retinoblastoma

 
External photo of leukocoria

 
Fundus photo of calcified intraocular mass

 
Untreated retinoblastoma

 
Gross photo with sagittal cut of exophytic retinoblastoma

 
Gross photo of exophytic retinoblastoma with exudate

 
Retinoblastoma with both exophytic and endophytic growth

 
Pseudorosettes in retinoblastoma

 
Dystrophic calcification

 
Flexner-Wintersteiner rosettes in retinoblastoma

 
Alcian blue stain of Flexner-Wintersteiner rosettes

 
Fleurette in retinoblastoma

 
Vitreous seeding of retinoblastoma

 
Retinoblastoma invading optic nerve

 
Retinoblastoma in the angle

Retinocytoma

Combined Hamartoma of the Retina and RPE

RPE Adenoma

RPE Adenocarcinoma

Myelinated Nerve Fibers

 
Fundus photo

Congenital Hypertrophy of the RPE (CHRPE)

Ocular Albinism

Oculocutaneous Albinism

References

Harper RA. Basic Ophthalmology. Amer Academy of Ophthalmology; 2010.
Yanoff M, Fine BS. Ocular Pathology, A Text and Atlas. Lippincott Williams & Wilkins; 1989.