Osseous and Adipocytic Differentiations in the Intraocular Lens and Vitreous

Frederick A. Jakobiec, Lina Ma, Natalie Wolkow, J. Douglas Cameron, Amy Maltry

Research output: Contribution to journalArticle

Abstract

Purpose To analyze 3 unusual mesenchymal transformations within the eye: adipose or osseous metaplasia of the lens and adipose tissue in the vitreous cavity. Design Observational case series. Methods Reevaluation of clinicopathologic diagnoses and histopathologic findings in sections stained with hematoxylin-eosin, periodic acid–Schiff (PAS) reaction, and Masson trichrome method. Results The 3 cases of mesenchymal transformation occurred in microphthalmic eyes with persistent hyperplastic primary vitreous (more recently termed persistent fetal vasculature). In 1 case there was total lens replacement with lamellar bone; in another, total replacement of the crystalline lens by adipose tissue; and in a third, an anomalous pocket of adipose tissue in the central vitreous. Multifocal remnants of the lens capsule were seen in the osseous case but were absent from the adipocytic cases. The vitreous adipose tissue was surrounded by an elaborate capillary plexus with an empty, collapsed PAS-positive lens capsule in the pupillary region. Anterior pigmented neuroectodermal disorganization, dysgenesis of angle structures, and a hypoplastic or disorganized iris were also observed in the 3 cases. Conclusions After review of the literature, it appears that lenticular osseous replacement occurs more often than adipocytic. In addition to vascularization of the lens through a capsular dehiscence, other causes are explored, including direct epithelial-mesenchymal transformations of the lens epithelium or, less likely, of the disorganized adjacent neuroectoderm. The focus of vitreous adipose tissue may represent a transformed luxated lens extruded from its capsule, which was left behind in the pupillary zone.

Original languageEnglish (US)
Pages (from-to)77-88
Number of pages12
JournalAmerican Journal of Ophthalmology
Volume186
DOIs
StatePublished - Feb 1 2018

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Intraocular Lenses
Lenses
Adipose Tissue
Capsules
Persistent Hyperplastic Primary Vitreous
Neural Plate
Crystalline Lens
Epithelial-Mesenchymal Transition
Metaplasia
Iris
Hematoxylin
Eosine Yellowish-(YS)
Epithelium
Bone and Bones

PubMed: MeSH publication types

  • Case Reports
  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

Cite this

Osseous and Adipocytic Differentiations in the Intraocular Lens and Vitreous. / Jakobiec, Frederick A.; Ma, Lina; Wolkow, Natalie; Cameron, J. Douglas; Maltry, Amy.

In: American Journal of Ophthalmology, Vol. 186, 01.02.2018, p. 77-88.

Research output: Contribution to journalArticle

Jakobiec, Frederick A. ; Ma, Lina ; Wolkow, Natalie ; Cameron, J. Douglas ; Maltry, Amy. / Osseous and Adipocytic Differentiations in the Intraocular Lens and Vitreous. In: American Journal of Ophthalmology. 2018 ; Vol. 186. pp. 77-88.
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