J Eshagian | PubMed Health

PubMed1982

Human posterior subcapsular cataracts.

Clinically and pathologically there are two kinds of posterior subcapsular cataracts: vacuolar-lacy and solid plaque. Vacuolar opacities occur in senile, diabetic, retinitis pigmentosa, steroid, and secondary cataracts (Elschnig pearls). Plaque opacities occur in congenital polar, myotonic dystrophy, and Turner syndrome (chromosome XO) cataracts. The vacuolar opacities tend to be more superficial (closer to the posterior capsule), whereas the plaque opacities are generally slightly deeper (more cortical). The vacuolar opacities show cellular proliferation of aberrantly migrated lens epithelial cells in the posterior pole which have added damage to the cataract by secretion of basement membrane, intra- and extra-cellular filaments, and release of cytolytic lysozymes causing liquefaction and necrosis. The plaque opacities are acellular. Both types of cataracts show breakdown of lens fibres into rounded up disorganized globules and some membranous whorls. The liquefied vacuolar opacity is more readily removed by extracapsular cataract extraction, but the retention of nucleated lens epithelial cells in the vacuolar type of opacity is the source of a secondary cataract or Hirchberg-Elschnig pearls which require a discussion or membranectomy to clear the visual axis. This article will review the salient features in the histopathology (light and electron microscopy) and morphology of PSC and amalgamate the findings reported by several investigators (Eshagian and Streeten, 1975; Eshagian, March, Goossens, and Rafferty, 1978, 1978; Eshagian, Rafferty, and Goossens, 1980, 1981; Eshagian, Rafferty, Goossens, and March, 1979; 1980; Streeten and Eshagian, 1978).

Adult↗

PubMed1981

Human cataracta complicata. Clinicopathologic correlation.

Complicated cataracts of the posterior subcapsular zone may be associated with a number os systemic conditions. Cataracts from patients with retinitis pigmentosa, Turner's syndrome, myotonic dystrophy, or those who were taking corticosteroids were examined clinically and pathologically after intracapsular cataract extraction. Two major types of posterior subcapsular opacities were observed: one type had multiple vacuoles, while the other type was a more solid appearing (plaque-like or snowball) opacity clinically. The predominant morphologic counterpart (by light and electron microscopy) of the vacuolar opacity is liquefactive necrosis with aberrantly migrated epithelia cells growing into the cataract. In the plaque-like or snowball opacity, the lens fibers are generally disorganized into round globules. The clinical significance is that the vacuolar-liquified posterior subcapsular cataract may be more easily removed by extracapsular methods than the plaque-like opacity; however, the proliferative cells in the vacuolar type are probably the source of an after-cataract membrane that may require discussion.

Adrenal Cortex Hormones↗