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Review
. 2020 Jan;6(1):3-9.
doi: 10.1159/000495724. Epub 2019 May 14.

Multimodal Imaging and Histopathological Evaluation of Berger's Space

Virginia Mares  1   2 , Marcio B Nehemy  2 , Diva R Salomão  1   3 , Shannon Goddard  1 , Jaime Tesmer  1 , Jose S Pulido  1
Affiliations
Review

Multimodal Imaging and Histopathological Evaluation of Berger's Space

Virginia Mares et al. Ocul Oncol Pathol. 2020 Jan.

Abstract

Objective: To demonstrate the multimodal imaging and histopathology of Berger's space.

Methods: We conducted a retrospective in vivo analysis of 4 patients demonstrating Berger's space with intraocular pathological conditions, documented by slit-lamp biomicroscopic photography and, in 2 patients, also by optical coherence tomography (OCT). Additionally, we carried out a retrospective histological study of 7 enucleated eyes with retinoblastoma demonstrating Berger's space. A review of the literature was also performed.

Results: Two eyes had slit-lamp photographs. One case showed Berger's space surrounded by vitreous hemorrhage. In the other case, amyloid was trapped within Berger's space. In another 2 eyes that were pseudophakic, Berger's space was visible on anterior segment OCT. One had amyloid trapped in Berger's space that could be seen with OCT. The histological review of the 7 enucleated eyes with advanced retinoblastoma demonstrated the presence of pyknotic cells in Berger's space.

Conclusions: Berger's space is an actual space in pathological conditions and can be an important site of pathology. Additionally, to our knowledge, this is the first time that Berger's space has been documented by anterior segment OCT in a clinical setting.

Keywords: Amyloid; Berger's space; Optical coherence tomography; Vitreous.

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Conflict of interest statement

No conflicting relationship exists for V.M., M.B.N., or D.R.S. J.S.P. has stock in LAgen Laboratories, which supplies induced pluripotent stem cell-derived retinal pigment epithelial cells for in vitro studies and has no relevant financial interests.

Figures

Fig. 1
Fig. 1
Amyloid material confined to Berger's space before capsulotomy.
Fig. 2
Fig. 2
Vitreous hemorrhage delineating Berger's space with blood inside inferiorly (arrow).
Fig. 3
Fig. 3
Berger's space in a pseudophakic patient on anterior segment OCT. The arrow shows the anterior hyaloid and Berger's space.
Fig. 4
Fig. 4
a Amyloid material in the retrolental space, one spot of amyloid material being indicated by the arrow. b Amyloid material attached to the fovea demonstrated by OCT. c Berger's space demonstrated by anterior segment OCT, with amyloid material inside it. The arrows identify amyloid material trapped in the anterior hyaloid and within Berger's space.
Fig. 5
Fig. 5
a Berger's space in a histopathological slide from a patient with advanced retinoblastoma from the year 1922. Arrow: Berger's space. H&E. ×20. b Magnified image from the same patient. The arrow shows probable proteinaceous and pyknotic cells within the space. H&E. ×40. c Lens, tumor cells, and Berger's space. PAS. ×20. d Berger's space with a pyknotic nucleus. PAS. ×100. e Retinoblastoma and probable pyknotic cells in Berger's space. PAS. ×100. f Retinoblastoma and Berger's space. PAS. ×100.
See this image and copyright information in PMC

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