September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intraocular Extramedullary Hematopoiesis: A Clinicopathologic Case Series
Author Affiliations & Notes
  • Oliver Gordon Fischer
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami Beach, Florida, United States
  • Maria Paula Fernandez
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami Beach, Florida, United States
  • Francisco Vega
    Pathology, University of Miami, Miami, Florida, United States
  • Sander R Dubovy
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami Beach, Florida, United States
  • Footnotes
    Commercial Relationships   Oliver Fischer, None; Maria Paula Fernandez, None; Francisco Vega, None; Sander Dubovy, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2431. doi:
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      Oliver Gordon Fischer, Maria Paula Fernandez, Francisco Vega, Sander R Dubovy; Intraocular Extramedullary Hematopoiesis: A Clinicopathologic Case Series. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2431.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Intraocular choroidal extramedullary hematopoiesis is well recognized in the neonate, however it is extremely rare in adults. We performed a non-comparative, consecutive case series study to further characterize the clinicopathologic characteristics in 45 cases of intraocular extramedullary hematopoiesis.

Methods : In a non-comparative, consecutive case series, the database at the Florida Lions Ocular Pathology Laboratory at Bascom Palmer Eye Institute, University of Miami Hospital was searched for surgical specimens diagnosed with intraocular extramedullary hematopoiesis on light microscopic examination for the time period of 1998 to 2015. The specimens and medical records were reviewed for demographics, clinical presentation and history of trauma. Clinicopathological features were then evaluated. IRB approval was obtained prior to the beginning of this study.

Results : Forty-five cases of intraocular extramedullary hematopoiesis were identified that occurred in 29 males and 16 females ranging in age from 2 weeks to 32 weeks old (Average age of 10.8 ± 1.1 weeks old). One case occurred in a 43 year old adult male. 10 cases (22.2%) occurred bilaterally and 35 cases (77.8%) occurred in a single eye. 25 cases (45.5%) occurred in the right eye and 30 cases in the left eye (54.5%). All cases of intraocular extramedullary hematopoiesis occurred within the choroid. The iron stain was focally positive within areas of extramedullary hematopoiesis in 25 cases (55.6%) and negative in 20 cases (44.4%). Intraocular hemorrhage was identified in 11 cases (24.4%) and not present in 34 cases (75.6%).

Conclusions : Forty-five cases of intraocular extramedullary hematopoiesis were identified, occurring primarily in infants with an average age of 10.8 ± 1.1 weeks old. One case is reported in a 43 year-old male. All cases occurred within the choroid and most were unilateral. To our knowledge, this study represents the largest case-series of intraocular extramedullary hematopoiesis.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

60x H&E reveals hematopoietic precursor cells within the choroid of a 2 week old male.

60x H&E reveals hematopoietic precursor cells within the choroid of a 2 week old male.

 

Image 1. A. 60x H&E of the choroid demonstrates the RPE layer, erythrocytes, and progenitor cells. B. 60x PAS stain demonstrating normoblasts (circular to eosinophilic cytoplasm with dense dark nuclei) and myeloblasts. C. 60x Iron stain highlights hemosiderin deposition within progenitor precursor cells.

Image 1. A. 60x H&E of the choroid demonstrates the RPE layer, erythrocytes, and progenitor cells. B. 60x PAS stain demonstrating normoblasts (circular to eosinophilic cytoplasm with dense dark nuclei) and myeloblasts. C. 60x Iron stain highlights hemosiderin deposition within progenitor precursor cells.

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