Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
An iris cyst, or uveal cyst, is a small hollow structure either attached to the iris of the eye or floating free in the anterior chamber. An iris cyst is composed of a single cell layer of epithelium and is filled with fluid. It is most commonly seen as secondary to inflammation in the eye, especially with canine glaucoma. They are most commonly seen in dogs. Golden Retrievers, Labrador Retrievers, and Boston Terriers are the most commonly affected breeds. Iris cysts also occur in cats and horses. The cysts are usually free floating in dogs, attached to the pupillary margin in cats, and present in the interior of the iris (especially blue irises) in horses.
Iris cysts usually cause no symptoms, but in large numbers they can cause glaucoma by obstructing the drainage angle of the eye. Golden Retrievers may have a higher rate of glaucoma associated with iris cysts.
Iris cysts need to be differentiated from iris melanoma, a tumor, by demonstrating their hollowness. A light directed at an iris cyst will cause it to transilluminate. Iris cysts can be collapsed if necessary by a veterinarian with a small needle carefully introduced into the anterior chamber. The cysts may also be destroyed by use of a semiconductor diode laser.
Diagnosis is made by an ophthalmologist or optometrist based on the clinical presentation. One indication can be the Amsler sign, which is the presence of blood (hyphema) in the aspirated vitreous fluid, in paracentesis of the anterior chamber. This is caused due to iris atrophy usually seen in FHI and exposure of the fragile iris vasculature to the vitreous fluid. The sudden change of pressure in the anterior chamber upon suction induced by the paracentesis, or during a cataract surgery, causes bursting of the fragile superficial iris capillaries resultsing in micro-bleeding. This is one clinical diagnostic sign of FHI slit lamp examination shows stringy keratic precipitates
The diagnostic process typically begins with a medical history workup followed by a medical examination by a physician. Imaging tests, such as CT scans and MRIs, help provide a clearer picture. The physician typically looks for fluid (or other bodily substance) filled sacs to appear in the scans, as is shown in the CT scan of a colloid cyst. A primary health care provider will refer an individual to a neurologist or neurosurgeon for further examination. Other diagnostic methods include radiological examinations and macroscopic examinations. After a diagnosis has been made, immunohistochemistry may be used to differentiate between epithelial cysts and arachnoid cysts. These examinations are useful to get a general idea of possible treatment options, but can be unsatisfactory to diagnose CNS cysts. Professionals still do not fully understand how cysts form; however, analyzing the walls of different cyst types, using electron microscopes and light microscopes, has proven to be the best diagnostic tool. This has led to more accurate cyst classification and correct course of action for treatments that are cyst specific. In the past, before imaging scans or tests were available, medical professionals could only diagnose cysts via exploratory surgery.
Epidermoid cysts are usually diagnosed when a person notices a bump on their skin and seeks medical attention. The definitive diagnosis is made after excision by a pathologist based on microscopic appearance of a cystic lesion lined by cornified epithelium containing lamellated keratin without calcifications. They can also be seen as isointense lesions on MRI or hyperintensities on FLAIR.
Plateau iris is a medical condition of the eye resulting from pushing of peripheral part of iris forward, by the large or anteriorly placed ciliary body causing angle closer glaucoma.
http://image.slidesharecdn.com/gonioscopy-140211072931-phpapp01/95/gonioscopy-70-638.jpg?cb=1392103893
this configuration is usually corrected by iridectomy.
if the glaucoma persists even after iridectomy then it is called plateau iris syndrome, this is managed by miotics or laser peripheral iridoplasty
The United States Preventive Services Task Force as of 2013 states there is insufficient evidence to recommend for or against screening for glaucoma. Therefore, there is no national screening program in the US. Screening, however, is recommended starting at age 40 by the American Academy of Ophthalmology.
There is a glaucoma screening program in the UK. Those at risk are advised to have a dilated eye examination at least once a year.
A small dermoid cyst on the coccyx can be difficult to distinguish from a pilonidal cyst. This is partly because both can be full of hair. A pilonidal cyst is a pilonidal sinus that is obstructed. Any teratoma near the body surface may develop a sinus or a fistula, or even a cluster of these. Such is the case of Canadian Football League linebacker Tyrone Jones, whose teratoma was discovered when he blew a tooth out of his nose.
Patients usually do not require treatment due to benign nature of the disease. In case cataract develops patients generally do well with cataract surgery.
Most cysts are discovered as a chance finding on routine dental radiography. On an x-ray, cysts appear as radiolucent (dark) areas with radiopaque (white) borders. Cysts are usually unilocular, but may also be multilocular. Sometimes aspiration is used to aid diagnosis of a cystic lesion, e.g. fluid aspirate from a radicular cyst may appear straw colored and display shimmering due to cholesterol content. Almost always, the cyst lining is sent to a pathologist for histopathologic examination after it has been surgically removed. This means that the exact diagnosis of the type of cyst is often made in retrospect.
Treatment for dermoid cyst is complete surgical removal, preferably in one piece and without any spillage of cyst contents. Marsupialization, a surgical technique often used to treat pilonidal cyst, is inappropriate for dermoid cyst due to the risk of malignancy.
The association of dermoid cysts with pregnancy has been increasingly reported. They usually present the dilemma of weighing the risks of surgery and anesthesia versus the risks of untreated adnexal mass. Most references state that it is more feasible to treat bilateral dermoid cysts of the ovaries discovered during pregnancy if they grow beyond 6 cm in diameter.
Corneal and Retinal Topography: computerized tests that maps the surface of the retina, or the curvature of the cornea.
Fluorescein Angiogram: evaluation of blood circulation in the retina.
Dilated Pupillary Exam: special drops expand the pupil, which then allows doctors to examine the retina.
Slit-Lamp Exam: By shining a small beam of light in the eye, eye doctors can diagnose cataracts, glaucoma, retinal detachment, macular degeneration, injuries to the cornea, and dry eye disease.
Ultrasound: Provides a picture of the eye’s internal structure, and can evaluate ocular tumors, or the retina if its suffering from cataracts or hemorrhages.
Clinical features can be found in the subhyoid portion of the tract and 75% present as midline swellings. The remainder can be found as far lateral as the lateral tip of the hyoid bone.
Typically, the cyst will move upwards on protrusion of the tongue, given its attachment to the embryonic duct, as well as on swallowing, due to attachment of the tract to the foramen caecum.
Since the condition appears to slowly subside or diminish on its own, there are no specific treatments for this condition available.
Some precautions include regular visits to an ophthalmologist or optometrist and general testing of the pupil and internal eye through fundamental examinations (listed below). The examinations can determine if any of the muscles of the eye or retina, which is linked to the pupil, have any problems that could relate to the tadpole pupil condition.
Diagnosis of a thyroglossal duct cyst requires a medical professional, and is usually done by a physical examination. It is important to identify whether or not the thyroglossal cyst contains any thyroid tissue, as it can define the degree of cyst that is being dealt with.
Diagnostic procedures for a thyroglossal cyst include:
Sebaceous cysts generally do not require medical treatment. However, if they continue to grow, they may become unsightly, painful, infected, or all of the above.
The clinical management of a cyst of Montgomery depends upon the symptoms of the patient.
If there are no signs of infection, a cyst of Montgomery can be observed, because more than 80% resolve spontaneously, over only a few months. However, in some cases, spontaneous resolution may take up two years. In such cases, a repeat ultrasonography may become necessary. If, however, the patient has signs of an infection, for example reddening (erythema), warmth, pain and tenderness, a treatment for mastitis can be initiated, which may include antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). With treatment, inflammatory changes usually disappear quickly. In rare cases, drainage may become necessary. A surgical treatment of a cyst of Montgomery, i.e. a resection, may become necessary only if a cyst of Montgomery persists, or the diagnosis is questioned clinically.
The prognosis seems to be excellent. In one series, all adolescent patients with a cyst of Montgomery had a favourable outcome.
A cyst of Montgomery may be asymptomatic. Yet, a cyst of Montgomery usually is diagnosed when a female patient, 10–20 years of age, complains to a healthcare professional of breast pain (mastalgia), inflammation or a palpable nodule in the breast. The diagnosis is made clinically, when a palpable nodule is felt in the retroareolar area.
The diagnosis can be confirmed with ultrasonography, frequently showing a simple cyst in the retroareolar area. In some patients, multiple cysts or bilateral cysts may exist. Cysts of Montgomery may have liquid content with an echogenic or calcific sediment.
Treatment ranges from simple enucleation of the cyst to curettage to resection. There are cysts—e.g., buccal bifurcation cyst—that resolve on their own, in which just close observation may be employed, unless it is infected and symptomatic.
Enucleation (surgical removal of the eye) is the treatment of choice for large ciliary body melanomas. Small or medium sized tumors may be treated by an "iridocyclectomy". Radiotherapy may be appropriate in selected cases.
A neurosurgeon may open a portion of the body and insert a shunt into cerebral spinal fluid (CSF) filled cysts to allow drainage into CSF pathways. The fluid from the cyst is then drained into the abdomen, the body reabsorbs the fluid (reabsorption of fluid does not cause any harm). This type of surgical treatment is often performed to relieve pressure on the brain from a cyst within the cerebral cortex.
Surgical excision is required to treat a trichilemmal cyst. The method of treatment varies depending on the physician's training. Most physicians perform the procedure under local anesthetic. Others prefer a more conservative approach. This involves the use of a small punch biopsy about 1/4 the diameter of the cyst. The punch biopsy is used to enter the cyst cavity. The content of the cyst is emptied, leaving an empty sac. As the pilar cyst wall is the thickest and most durable of the many varieties of cysts, it can be grabbed with forceps and pulled out of the small incision. This method is best performed on cysts larger than a pea which have formed a thick enough wall to be easily identified after the sac is emptied. Small cysts have walls that are thin, and easily fragmented on traction. This increases the likelihood of cyst recurrence. This method often results in only a small scar, and very little if any bleeding.
Typically a coloboma appears oval or comet shaped with round end towards the centre. There may be a few vessels (retinal or choroidal) at the edges. The surface may have irregular depression.
Screening for glaucoma is usually performed as part of a standard eye examination performed by optometrists and ophthalmologists. Testing for glaucoma should include measurements of the intraocular pressure via tonometry, anterior chamber angle examination or gonioscopy, and examination of the optic nerve to look for any visible damage to it, or change in the cup-to-disc ratio and also rim appearance and vascular change. A formal visual field test should be performed. The retinal nerve fiber layer can be assessed with imaging techniques such as optical coherence tomography, scanning laser polarimetry, and/or scanning laser ophthalmoscopy (Heidelberg retinal tomogram).
Owing to the sensitivity of all methods of tonometry to corneal thickness, methods such as Goldmann tonometry should be augmented with pachymetry to measure the central corneal thickness (CCT). A thicker-than-average cornea can result in a pressure reading higher than the 'true' pressure whereas a thinner-than-average cornea can produce a pressure reading lower than the 'true' pressure.
Because pressure measurement error can be caused by more than just CCT (i.e., corneal hydration, elastic properties, etc.), it is impossible to 'adjust' pressure measurements based only on CCT measurements. The frequency doubling illusion can also be used to detect glaucoma with the use of a frequency doubling technology perimeter.
Examination for glaucoma also could be assessed with more attention given to sex, race, history of drug use, refraction, inheritance and family history.
Glaucoma has been classified into specific types:
Colloid cysts can be diagnosed by symptoms presented. Additional testing will be required and the colloid cyst symptoms can resemble those of other diseases. MRI and CT scans are often used to confirm diagnosis.
It occurs most commonly in the sixth decade.
- External signs include dilated episcleral blood vessels ("sentinel vessels"). Extraocular erosion may produce a dark mass beneath the conjunctiva.
- Pressure on the lens by the enlarging tumor can cause astigmatism, sublaxtion of the lens and formation of a localised lens opacity.
- The tumor can erode forward through the iris root and mimic an iris melanoma.
- Retinal detachment can be rarely caused by posterior extension of the tumor.
- Anterior uveitis is an uncommon presentation and occurs due to tumor necrosis.
- Cirumferentially growing tumors carry a bad prognosis as they are diagnosed late.
- At times the tumor is detected as an incidental finding during routine examination.
The tumour is usually diagnosed by clinical examination with a slit-lamp utilising a triple mirror contact lens. Ultrasonography and fine needle aspiration biopsy (FNAB) are also sometimes helpful in confirming the diagnosis.