Intraokulaarsed lesioonid
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- Nathan Norris
- 7 years ago
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1 Intraokulaarsed lesioonid
2 Anatoomia Globus on ringjas, D-ga 2,5 cm Maht ~6,5 ml 3 kesta: reetina, koroidea, skleera Skleerat katab anterioorsel konjuktiiv Skleera läheb üle korneaks, nende vahel on limbus KT-ga on raske eristada erinevaid kestasid, väga hea lubjastuste avastamiseks Ajay Malhotra, MD, Frank J. Minja, MD, Alison Crum, MD; Ocular Anatomy and Cross-Sectional Imaging of the Eye; Seminars in Ultrasound, CT and MRI; 2011
3 Vascular Infectious Trauma Acquired Metabolic Idiopathic Neoplastic Congenital Drugs VITAMIN C & D Eeskamber/ tagakamber Intra-/extraconal
4 Leukokooria Leukokooria (valge pupill)- reetinalt ei peegeldu valgus ja seda põhjustab igasugune tihe kude, mis häirib valguse kulgu globuses RB 56-72% PHPV 19-28% Läätsetagune fibroplaasia 5-13% Post. katarrakt 13,5% Koloboomija koroidea defektid 11,5% Coat'i tõbi 4-16% Ellen M. Chung, LTC, MC, Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
5 Persistentne hüperplastiline primaarne klaaskeha (Persistent Hyperplastic Primary Vitreous) Fibrovaskulaarse püsiva ja hüperplastilise koega ( embrüoloogilisest prim. klaaskehast ja a.hyaloidea süsteemist) Sageduselt teine leukokooria põhjustaja 19-28%, mikroftalm (AP alla 21 mm) esineb 61-92% Kongenitaalne, pole päritav, % unilateraalne Esimestel elukuudel esineb fibrovaskulaarse koe hemorraagiat Ellen M. Chung, LTC, MC, Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
6 2. aastane poiss S-kujuline (ka lehtri) lisakude läätse ja diski vahel, mis kontrasteerub Ei esine lubjastusi KT paremini eristab retinoblastoomist, MRT aga teistest pseudoretinoblastoomidest Ellen M. Chung, LTC, MC, Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
7 3 kuu vanune Sagitaalsed T1. MRT-s võib klaaskeha signaal olla erinev. Vereproduktid kihistuvad subhüaloidsesse või subretinaalsesse ruumi. Paremal norm. Silm. Ellen M. Chung, LTC, MC, Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
8 Coat'i tõbi... kongenit. mittepäritav, unilateraalne reetina vaskulaarne malformatsioon teleangiektaasiate ja aneurüsmidega Patogenees: lipiidide ja proteiinide rikas vedelik koguneb reetinasse või selle alla --> reetina irdumine Kliiniliselt mõnikord raske dif. RB-st Tavaliselt avastatakse 6-8 a. vanustel, 2/3 XY Strabism, leukokooria Kontasteerumine toimub mööda irdunut reetinat ning pk-s, kus reetina uuesti kinnitub Lubjastusi ei esine David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology 2010
9 18 kuune poisslaps KT-l hüperdensne klaaskeha (eksudaat) Kaltsifikaate esineb harva K-ainega anterioorne subretinaalne lineaarne V-kujuline kontrasteerumine ( reetina paksenemine ning teleangiektaasiad) Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
10 18 kuune poisslaps T1 rasvsupr. k-ainega Väljendunud reetina irdumine, ei kontrasteeru Subretinaalne vedelik intensiivne T1 ja T2-s Spektroskoopial eksudaadil kõrge piik ppm Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
11 Koroidea hemangioom Kongenit. vaskulaarne hamartoom, keskmine vanus ~31 a. 2 tüüpi: piirdunud vorm ja üksik lesioon Histol: kavernoosed, kapillaarsed, segavorm Teravalt piirdunud, asuvad globuse ekvaatorist allpool, suurenevad harva, kontr. intensiivselt Difuussed hemangioomid (Sturge-Webers.) haaravad koreideat ning võivad haarata ka tsiliaarkeha, iirist, episkleera, konjuktiivi ja limbust Wendy R. K. Smoker, MD Lindell R. Gentry, MD, Norbert K. Yee; Vascular Lesions of the Orbit: More than Meets The Eye; Radiographics 2008
12 Koroidea hemangioom Üksikut lesiooni vaja dif-da koroidea melanoomist MRT > KT Natiiv KT-uuring KT-uuring k-ainega Wendy R. K. Smoker, MD Lindell R. Gentry, MD, Norbert K. Yee; Vascular Lesions of the Orbit: More than Meets The Eye; Radiographics 2008
13 T1, T2 ja T1 rasvsupr. k-ainega T1 hüper-/ isoint. klaaskehaga T2 hüper-/isoint. klaaskehaga Intensiivselt kontrasteeruvad T2 isoint. aitab eristada uvea melanoomist (spets.93%, sensit. 96%) Wendy R. K. Smoker, MD Lindell R. Gentry, MD, Norbert K. Yee; Vascular Lesions of the Orbit: More than Meets The Eye; Radiographics 2008
14 Uveiit... koroidea, tsiliaarkeha või iirise põletikuga Enamik on idiopaatilised, viirused ( HSV) Sarkoidoos avaldub silmas enim uveiidina Kollageen-vaskulaarsed haigused võivad põhjustada uveiiti A really omniscient neuroradiologist may see enhancement of the uveal tract on highresolution MR to make the diagnosis
15 Posterioorne skleriit... infektsioonid ja autoimmuunhaigused Äge/ krooniline vorm Iseloomulik on tagumise uvea ja skleera kontrasteerumine Nodulaarne kontrast- dif. melanoomist Difussne kontrast.- dif. lümfoomist Võib esined reetina/ koroidea irdumine ja uveiit
16 Bilat. post. skleriit KT-l skleerade ebaregulaarne paksenemine ning kontrasteerumine T1 rasv supr. k-aine skleera laminaarne paksenemine ja kontrasteerumine ning silmamuna vähene deformatsioon Joseph Platnick, MD, Alison V. Crum, MD, Stephanie Soohoo, MD; The Globe: Infection,Inflammation, and Systemic Disease; Seminarsin Ultrasound, CT and MRI; 2011
17 Tsütomegaloviirus (CMV) Sagedaseim reetina ja koroidea oportunistilik inf. 1/4 AIDS haigetel, avaldub haiguse hilises staadiumis kui CD 4 arv < 50 ~90 % põhjustab visuse kaotust (ravita 3-6 kuu jooksul ) Toksoplasmoos, TB, Pneumocystis carinii ja HSV Hemorraagiad on iseloomulik, mistõttu KT-l hüperdense ning MRT-l varieeruva signaaliga Radioloogiliselt: uvea kontrasteerumine, reetina irdumine/ lubjastumine Joseph Platnick, MD, Alison V. Crum, MD, Stephanie Soohoo, MD; The Globe: Infection,Inflammation, and Systemic Disease; Seminars in Ultrasound, CT and MRI; 2011
18 CMV T1 k-ainega Parema uvea kontrast. AIDS haigel Natiiv KT-l parema silma reetina lubjastus AIDS haigel Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
19 Idiopaatiline orbita põletik( Orbita pseudotuumor)... idiopaatiline mittegranulomatoosne orbita põletik - intraokulaarne põletik, mis põhjustab uveiiti, keratiiti, retiniiti aga ka skleriiti ja episkleriiti Kliiniline diagnoos: per exclusionem Ühepoole proptoos, tugev valu, mis allub hästi steroidravile Orbita tuumoritest sageduselt III, mood. 6% orbita lesioonidest Tavaliselt ühepoolne, kahepoole haaratus viitab süsteemsele haigusele On täheldatud ka ekstraokulaarset levikut Lakshmana Das Narla, MD Beverley Newman, MD Stephanie S. Spottswood, MD; Inflammatory Pseudotumor, Radiographics 2003
20 Idiopaatiline orbita põletik Radioloogiliselt: silma misatahes struktuuri paksenemine ja kontrasteerumine (uvea ja skleera 33 %) T1 iso-/hüpointens. võrreldes lihastega ja T2 suhteliselt hüpointens. võrreldes teiste silma Tu-ga Lakshmana Das Narla, MD Beverley Newman, MD Stephanie S. Spottswood, MD; Inflammatory Pseudotumor, Radiographics 2003 Madhavi Patnana, Alexander B. Sevrukov, Khaled M. Elsayes; Inflammatory Pseudotumor: The Great Mimicker, AJR 2011
21 Idiopaatiline orbita põletik Sepahdari et al. ADC piirväärtus eristamaks beniigseid ja maliigseid T2 hüpointensiivseid lesioone Maliigsetel lesioonidel on madalam ADC kui beniigsetel (p< 0,02) Lümfoomidel madalam ADC kui pseudotuumoritel ( p< 0,001) Madhavi Patnana, Alexander B. Sevrukov, Khaled M. Elsayes; Inflammatory Pseudotumor: The Great Mimicker, AJR 2011
22 Periorbitaalne tselluliit... orbita ees asetsevate kudede põletik silmalaugude põletik, konjuktiviit (proptoosi ja nägemise kadu ei esine, silmade liigutamine ei ole piiratud) periorbitaalne vs. orbitaalne tselluliit (septum!) Orbitaalne tsellulit: AB i/v, kirurgiline dekompressioon-eriti kui põletik pärineb etmoid-/sfenoidsiinustes
23 Periorbitaalne tselluliit Vasaku silma periorbitaalsete pehmete kudede turse T1 rasv supr. ja k- ainega. Orbita ja periorbitaalsete kudede kontrasteerumine Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
24 Toxocara canis'e infektsioon T. canis'e vastne sureb -> põletikuline reaktsioon (nagu neurotsüstitserkoos) Lesioonid tekivad kuid-aastaid peale infekts. Põhjustavad ühepoolset leukokooriat Sagedasti esineb reetina irdumist Radioloogiline kuvamine on mittespetsiifiline AK-tiiter! T1 ja T2 hüperintensiivsed (aitab eristada RB-st), va. fibroseerumise korral, siis meentub RB (RB tavaliselt asetseb posterioorsel)
25 Toksokarioos Ei esine kaltsifikaate (eristamine RB-st) KT-l suht. difuusne, hüperdensne lesioon Täheldatud on skleera dif. paksenemist ja reetina irdumist KT-l võib sarnaneda Coat'i tõvele Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
26 Trauma Sagedamini esinevad eesmise kambri vigastused, läätse, silmamuna avatud vigatused, irdumised, võõrkehad, karotiidkavernoossed fistlid, n. opticuse vigastused Hinnata luulisi struktuure (herniatsioone),eesmist ja tagumist kambrit, läätse asetsust, võõrkehasid ja v. ophthalmicat ja n.opticust
27 Eesmise kambri vigastused Eesmise kambri mahu vähenemine-kornea latseratsioon Läätse täielik subluksatsioon Wayne S. Kubal, MD, Imaging of Orbital Trauma, Radiopraphics 2008
28 Globuse vigastused Globuse ruptuur (nn. tühja rehvi või vihmavarju sümptom) Globuse vigastus? Silmamune sees õhk. Iatrogeenne ( reetina kinnitus) Globuse vigatus? Võõrkeha? Iatrogeenne ( reetina kinnitus) Wayne S. Kubal, MD, Imaging of Orbital Trauma, Radiopraphics 2008
29 Irdumised
30 Reetina irdumine (erinevad pt.) Natiiv KT: klaaskehas tihe sisaldis ja reetina irdumine (veri või proteiinirikas vedelik) T2: reetina irdumine (seroosne vedelik) T1:reetine irdumine (hemorraagia), läätse implantaat Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
31 Koroidea irdumine Infektsioonid, ravimid ja trauma on kõige sagedasemad okulaarse hüpotoonia põhjustajad-> seroosne koroidea irdumine Hemorraagia? Valgurikas vedelik? Hemorraagia korral tegemist koroidea veresoonte vigastusegahalvem prognoos Hemorraagia korral asend ei muutu MRI eristamiseks! ( seroosne irdumine T1 ja T2 kõrge intens) Christina A. LeBedis, MD Osamu Sakai, MD, PhD; Nontraumatic Orbital Conditions:Diagnosiswith CT andmr Imaging in the Emergent Setting1; Radiographics 2008 Wayne S. Kubal, MD, Imaging of Orbital Trauma, Radiopraphics 2008
32 Tagumise hüaloidmembraani irdumine > 50 a. (maakula degener.) ja lastel PHPV Klaaskeha degener. ja veeldumine Retrohüaloidse ruumi vedelik muudab lokalisatsiooni asendi muutmisel Retrohüaloidset ruumi ja subretinaalset ruumi ei õnnestu alati dif. KT ja MRI Reetina või koroidea irdumise põhjuseks võib olla Tu! (lastel RB ja täiskasvanutel uvea melanoom) T1 ja T2 ning T1 rasv sup. k- ainega. Klaaskeha irdumine, klaaskeha oma basisega ei kinnitu reetinale (nooled) ning diski pk-s madala signaaliga ala -hemoraagia.
33 Lubjastused Suhteliselt sage juhuleid Sagedasemad trochlea lubjastused, skleera naastud, optikuse druusenid ning ja phthisis bulbi Harva infektsioonid ( toksoplasma, CMV, HV, TB) Vaskulaarsed ( ateroskleroos, fleboliit) Neoplaasia (RB, koroidea osteoom, meningioom) Hüperkaltseemia ( hüperparatüroidism, mts, vit. D)
34 Optikuse druusid Optikuse diski pk lubjastus lamina cribrosast ant. ~ 2 % Enamasti bilat. Aut. dom (variaabelse penetr.) Ka retinitis pigmentosa korral Pseudopapilloödeem Pole pehmekoelist komponenti ja ei kontrasteeru David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology 2010 Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
35 Trochlea lubjastjused M. obliquus sup. kõõluse lubjastus Vananedes ealine variant < 40.a diabeet? Võivad põhjustada valu ja piirata silmade liigutamist -tenosünoviit (Browni sündroom) Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
36 Skleera naastud. Phthisis bulbi M. rectus med(2/3) ja lat. pk-s Vanemaealistel Hüperparatüroidism ja hüpomagneseemia võivad põhjustada Phthisis kr. keel kurnumus Okulaarne degeneratsioon (trauma, kauakestev infektsioon) Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
37 Neoplaasiad Esinevad suhteliselt harva, 2350 /1,5 miljoni kasvaja kohta (USA 2009) 70% melanoom, 10 % RB ja 9% lamerakkkartsioom Enamik täiskasvanute silma primaarsetest kasvajatest ning mts.-dest haarab koroideat Diagnoosimine (oftalmoloogil limiteeritud vaade-katarakt, kornea varjustused), leviku ning ravivastuse hindamine David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology 2010 Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
38 Melanoom T1, T2 ja T1 k-ainega. Virginie Houle, MD Manon Bélair, MD, FRCPC, Guy S. Allaire, MD, FRCPC; AIRP Best Cases in Radiologic-Pathologic Correlation: Choroidal Melanoma; Radiographics 2011
39 Retinoblastoom Kõige sagedasem lapseea intraokulaarne kasvaja (1: sünni kohta) Tavaliselt avaldub enne 3. eluaastat 90% põhjuseks sporaadiline mutatsioon (unilateraalsed ning avalduvad hiljem) 10 % päritav (AD) ning nendest > 1/3 on bilat. ning seotud geenidega, mis soodustavad muid kasvajaid RB1 geen lok. 17 kromosoomi q14 lookuses Supressorgeeni mitte esinemine või superssorgeeni alleelide inaktivatsioon on vajalik RB tekkeks (Knudsoni kahe löögi teooria) Kuvamine on oluline retrobulbaarse leviku ning n.opticuse haaratuse hindamiseks Võib levida mööda n.opticust subarahn.-le, hematogeenselt aga ka lümfogeenselt (soodumus veritsustele) David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology 2010 Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
40 Retinoblastoom Päritav RB vorm -> neil esineb sagedasti mitteokulaarseid kasvajaid (PNET, käbikeha Tu, sarkoomid, melanoomid...) Trilateraal RB- bilat. RB ja käbikeha Tu! Radioloogiline leid sõltub: ekso-, endofüütne või infiltratiivne kasv KT-l: hüperdensne lesioon post. globuse pk-s, homo- /heterogeenne lubjastumine, mis ulatub klaaskehasse (95%!), kontrasteeruvad tagasihoidlikult (27,5%) < 3a. on okulaarsed lubjastused iseloomulikud ning nende mitte-esinemine muudab RB väga ebatõenäoliseks Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
41 Retinoblastoom MRT: T1 mõõduka intens, T2 hüpointens. 30% tekib kiiritusväljas 2. maligniseerumine (eriti pehmekoe kasvajaid) KT lubjastuste leidmiseks ning MR leviku hindamiseks Kontrasteerumine võib olla leviku ainuke indikaator 90% elulemus kui haaratud vaid globus 90% suremus kui levinud ekstraokulaarsele Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007 Ajay Malhotra, MD, Frank J. Minja, MD,* Alison Crum, MD; Ocular Anatomy and Cross-Sectional Imaging of the Eye; Seminars in Ultrasound, CT and MRI; 2011
42 Retinoblastoom Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007
43 Melanoom Uvea melanoom täiskasvanutel sagedaseim, tsiliaarkeha ning iirise lesioonid esinevad harva 5-8 juhtu in. kohta Diagnoos baseerub oftalmoskoopial, kliinikul ja transilluminatsioonil UH diagnostiline täpsus ~95% MR karakteristlik signaal, mis on seotud melaniini konts. (T1 hüper, T2 hüpo) Amelanotsüütne melanoom (1/4 uvea melanoomides) sarneneb teistele Tu-le (T1 hüpo, PDWI/ T2 hüper) KT-l on hüperdensne ja kontrasteerub Võib põhjustada reetina irdumist Levik ekstraokulaarsele on halvema prognoosiga Peamiselt hematogeensed mts. maksa (90%) ja kopsu (24%) Virginie Houle, MD Manon Bélair, MD, FRCPC, Guy S. Allaire, MD, FRCPC; AIRP Best Cases in Radiologic-Pathologic Correlation: Choroidal Melanoma; Radiographics 2011 H. Ric Harnsberger; Michelle A. Michael; Christine M. Gastonbury; Expert ddx: Head and Neck 2009
44 Medulloepitelioom... tsiliaarkeha mittepigmentepiteelist lähtunud Tu-ga, esinevad harva Tegemist beniigse või lokaalselt invasiivse Tuga, harva annavad kaugmetastaase Esineb nii lastel kui täiskasvanutel KT: hüperdensne mass tsiliaarkeha pk-s, harva reetinas, tagasihoidlik kuni mõõdukas kontrasteerumine
45 T1, T2, FLAIR, T1 rasvsupr. k-aine MR kuvamisel sarnaneb melanoomile (T1 hüper ja T2 hüpoint.), kontr. homogeenselt, võib esineda ka tsüstjaid alasid 25 % esineb kaltsif.-> dif.-da RB-st Kui pärineb reetinast ning esineb lubjastusi - pole võimalik dif.-da RB-st Ellen M. Chung, LTC, MC, USA Charles S. Specht, MD Jason W; Pediatric Orbit Tumors and Tumorlike Lesions: Neuroepithelial Lesions of the Ocular Globe and Optic Nerve, Radiographics 2007 David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology 2010
46 Koroidea osteoom Beniigne Tu Tavaliselt esineb noortel naistel Ühepoolsed Koroidea tagumises seinas, temporaalsel (jukstapapillaarsel) unifokaalne lubjastus MR signaal võib saraneda RB, KT-l luutihedus David M. Yousem; Robert I. Grossman; The Requisites: Neuradiology
47 Metastaasid Sagedamini: rinna ja kopsu kasvajad ning lümfoomid ja leukeemiad Hematogeenne levika. ciliaris post., lümfogeenne konjuktiivile ja silmalaugudele Kõige sagedamini koroidea ja uvea mts. Paljud põhjustavad ekstsentrilist uveaskleraalse äärise paksenemist Asüpomaatilised kui ei lokaliseeru foveas ega põhjusta reetina irdumist KT ja MRT retrobulbaarse haaratuse diagnoosimiseks ( kliiniliselt ei avaldu)
48 Metastaasid Koroidea lümfoom ja leukeemia sarnanevad MRT-l uvea melanoomile ja võivad põhjustada reetina irdumist MR: T1 isoint.->hüperint., T2 hüperint. ning kontrasteervad heterogeenselt Mutsiini produts. adenokartsinoomi mts. ning hemorraaglised mts. võivad simuleerida melanoomi (T1 hüper, T2 hüpo)
49 Rinnavähk, koroidea mts. Metastaasid T1,T2 ja T1 rasvsupr.k-aineg Mao kartsinoomkoroidea mts.
50 Kongenitaalsed PHPV- vaskulaarne lesioon: mikroftalmia, reetinaklaaskeha hemorraagia ja irdumine, Cloquet'i kanal. Norrietõbi on PHPV päritav vorm, millega kaasnevad krambihood, VAM ja katarakt Koloboom-silma mistahe struktuuri kongen. defekt (koroidea fissuuri mittetäielik sulgumine) Atüüpiline(iiris)/tüüpiline (globuse inferomed. osas ning koonusjas)
51 Koloboom Harva autos-dom ( 60% bilat) Kaasneda võivad orbita tsüstid ning kranio-tserebro ning näo pk. lõhestumised CHARGE sündroom Coloboma Heart defect Atresia of the choana Retard Growth and development Ear anomalies Andreas M. Rauschecker, PhD, Msc; Chirag V. Patel, MD ; Kristen W. Yeom, MD, High-Resolution MR Imaging of the Orbit in Patients with Retinoblastoma; Radiographics 2012 Mahmud Mossa-Basha, MD, and David M. Yousem, MD; Congenital cystic lesions of the neck, Applied Radiology 2013
52 Stafüloom... kornea või skleera õhenemine, mida katab uvea kude (tavaliselt posterolateraalsel) Enamik on kongenit., võivad esineda koos müoopiaga aga tekivad ka infektsiooni ja trauma korral Radioloogiliselt: globuse väljavõlvumine piirkonnas, mis ei kontrasteeru Ajay Malhotra, MD, Frank J. Minja, MD,* Alison Crum, MD; Ocular Anatomy and Cross-Sectional Imaging of the Eye; Seminars in Ultrasound, CT and MRI; 2011
53 Fakomatoosid... neurokutaansed sündroomid Reetina hamartoomid, hemangioomid ning hemangioblastoomid on tüüpilisemad Reetina astrotsütaarne hamartoom ( reetina astrotsütoom) Tuberoosse skleroosi (50%, 30 % bilat.), neurofibromatoosi ning harva ka von Hippel Lindau haiguse korral Tihti kaltsifitseeruvad ja eristamine RB-st võib osutuda raskeks Kasvavad aeglaselt ja ei metastaseeru Andreas M. Rauschecker, PhD, Msc; Chirag V. Patel, MD ; KristenW. Yeom, MD, High-Resolution MR Imaging of the Orbit in Patients with Retinoblastoma; Radiographics 2012
54 Enneaegsete retinopaatia... tekib pikaaegse hapnikravi tagajärjel Sõltub lapse kaalust, vanusest ja hapnikravi mahust 85-90% regresseeruvad KT: tihe lisamass globuse post. osas Võib esineda lubjastusi Dr. Tejas Kalyanpur, Dr. Mathew Cheriyan; Role of MRI and CT in Ocular and Orbital Diseases; Kerala Journal of Ophthalmology; 2009
55 Sagedamini teostatavad intervents. protseduurid on glaukoomi dreneerimine, kunstläätse paigaldamine, reetina kinnitamine (scleral buckling), silikooniga tamponeerimine, pneumaatiline retinopeksia ja globuse proteesid Glaukoomi dreen Pneumaatiline retinopeksia Silikoon tamponaad ja skleera kinnitused A.A. Roy, I. Davagnanam, J. Evanson Abnormalities of the globe; Clinical Radiology; 2012 Christina A. LeBedis, MD Osamu Sakai, MD, PhD; NontraumaticOrbital Conditions:Diagnosis with CT andmr Imaging in the Emergent Setting1; Radiographics 2008
56 Kunstläätsed Proteesid Skleera kinnitused
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