conjunctival lymphangiectasia clinicopathological features and surgical management l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Conjunctival Lymphangiectasia: Clinicopathological Features and Surgical Management PowerPoint Presentation
Download Presentation
Conjunctival Lymphangiectasia: Clinicopathological Features and Surgical Management

Loading in 2 Seconds...

play fullscreen
1 / 12

Conjunctival Lymphangiectasia: Clinicopathological Features and Surgical Management - PowerPoint PPT Presentation


  • 1593 Views
  • Uploaded on

Conjunctival Lymphangiectasia: Clinicopathological Features and Surgical Management. Douglas Lyall 1 Fiona Roberts 2 Sathish Srinivasan 1,3 1 Department of Ophthalmology, Ayr Hospital, Ayr, Scotland 2 Department of Pathology, Western Infirmary, Glasgow, Scotland

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Conjunctival Lymphangiectasia: Clinicopathological Features and Surgical Management' - paul


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
conjunctival lymphangiectasia clinicopathological features and surgical management

Conjunctival Lymphangiectasia:Clinicopathological Features and Surgical Management

Douglas Lyall 1

Fiona Roberts 2

Sathish Srinivasan 1,3

1 Department of Ophthalmology, Ayr Hospital, Ayr, Scotland

2 Department of Pathology, Western Infirmary, Glasgow, Scotland

3 University of Glasgow, Glasgow, Scotland

The authors have no financial interest in the subject matter of this poster

introduction
Introduction
  • Conjunctival Lymphangiectasia (CL) is a localised or diffuse dilatation of the lymphatic channels of the conjunctiva
  • This gives the clinical appearance of chemosis or of a mobile cyst within the conjunctiva
  • When localised it may be in response to underlying conjunctival disease
  • In diffuse cases it may be idiopathic or associated with systemic disease
  • Patients may complain of symptoms of ocular surface disease including irritation, epiphoria and blurred vision
  • Previously reported management strategies include simple excision, marsupialization and cryotherapy
purpose
Purpose
  • To report the clinicopathological features of CL
  • To describe surgical options available in managing this condition

Methods

  • Retrospective case note review of patients with a confirmed histopathological diagnosis of CL
  • Cases were identified from records of a regional ocular pathology centre
  • Data recorded:
  • Age at presentation
  • Gender
  • Presenting signs and symptoms
  • Histopathological features
  • Management and outcomes
results
Results
  • Demographics:
  • Presenting Characteristics:
  • Ocular Co-morbidity: Previous Ocular Surgery:
clinical appearances
Clinical Appearances

Fig. 1

Fig. 2

Fig. 3

Fig. 4

  • Inferotemporal translucent swelling of the bulbar conjunctiva in both eyes (arrowed)
anterior segment oct
Anterior Segment OCT

Fig. 5

Fig. 6

  • Anterior segment OCT images of both eyes showing cystic spaces within the conjunctiva
management of cases
Management of Cases
  • 14 eyes underwent simple excisional biopsy
  • 2 eyes had excisional biopsy combined with amniotic membrane transplantation (AMT) and fibrin glue
  • 4 eyes undergoing excisional biopsy had recurrence of chemosis and associated symptoms
  • 2 eyes undergoing excisional biopsy with AMT had no recurrence of chemosis

Outcomes

surgical excision with amt
Surgical Excision with AMT

Supplemental Video File

post operative appearance
Post Operative Appearance
  • Fig. 7: Appearances 2 weeks following surgery in the right eye (OD) with AMT. Minimal inflammation with no evidence of wound dehiscence
  • Fig. 8 & 9: Bilateral absorption of AMT with a well healed conjunctival surface and no recurrence of chemosis at 6 months

Fig. 7

Fig. 8

Fig. 9

histopathology findings
Histopathology Findings
  • Squamous metaplasia of the surface mucosa (arrow)
  • Marked edema of the lamina propria and stroma with numerous dilated lymphatic channels (asterisk)
  • Chronic inflammation of the stroma including lymphocytes and plasma cells (arrow head)

Fig. 10

Fig. 11

conclusions
Conclusions
  • Clinical Findings of Conjunctival Lymphangiectasia
    • Chemosis and hyperaemia occurs in both diffuse and localised forms
    • It is associated with various ocular surface disease conditions and previous ocular surgery
  • Histopathological Findings
    • Diffuse dilatation of conjunctival lymphatic channels and secondary stromal oedema
    • Associated with secondary chronic conjunctival inflammation
conclusions12
Conclusions
  • Surgical management options of CL in our series include:
    • Total excisional biopsy
    • Total excisional biopsy with amniotic membrane transplantation and fibrin glue
  • Proposed benefits of performing excision with AMT and fibrin glue:
    • Eliminates need for suturing and shortens operating time
    • Reduces postoperative inflammation and discomfort