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anatomyofuvea , iris , ciliary body , choroid
- 1. Anatomy of Uvea PRESENTEDBY : Dr MOHIT KUMAR JHA OPHTHALMOLOGY RESIDENT CIVIL HOSPITAL , PANCHKULA
- 2. Introduction UVEA – MiddleVascular Part of Eyeball 3 parts : 1. IRIS 2. CILIARY BODY 3. CHOROID Entire Uveal tract is developmentally , structurally and functionally one indivisible structure
- 3. Embryology IRIS- • Both layersof epithelium derived from marginal region of optic cup (neuroectoderm) • Sphincter and dilator pupillae- anterior epithelium (neuroectoderm) • Stroma and vessels- vascular mesoderm CILIARY BODY • Both Epithelium from neuroectoderm • Ciliary processes from ciliary epithelium • Stroma and blood vessels – mesoderm
- 4. TIMELINE 9TH WEEK GESTATION-ciliary body appears 12TH WEEK GESTATION- sphincter pupillae appears 5TH MONTH- all layers of choroid seen ,. iris fully developed 6TH MONTH- dilator muscle begins to form, sphincter muscle is fully formed POSTNATAL PERIOD- dilator muscle fully formed by 5 years, iris stromal pigment develops after birth
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- 9. Microscopic structure • FOURLAYERS- • a)Anterior limiting layer- consists melanocytes and fibroblasts ,Previously called endothelial layer. • Colour of iris depends on this layer • Blue iris- thin layer and few pigment cells • Brown iris- thick and doubly pigmented • b) Iris stroma- • Forms main bulk • Consists of loosely arranged collagenous network with mucopolysaccharide ground substance • Structures embedded-muscles , vessels , nerves , pigment cells and other cells which include fibroblast , lymphocytes and macrophages
- 11. Sphincter pupillae- 1mm broad circular band in pupillary area • flat bars of plain muscle fibres • derived by ectoderm • supplied by parasympathetic fibres by 3rd nerve • constricts pupil Dilator pupillae- lies in posterior part of ciliary zone • supplied by cervical sympathetics • dilates pupil
- 12. c) Anterior epitheliallayer • anterior continuation of pigment epithelium of retina and ciliary body • Lacks melanocytes • Basal processes- give rise to dilator pupillae • D)Posterior pigmented epithelial layer • Anterior continuation of non pigmented epithelium of ciliary body • Derived from internal layer of optic cup • Forms pigmented frill
- 13. Ciliary Body • Forwardcontinuation of choroid at ora serrata • Triangular in cut section, ant side of its form part of angle , in middle attached to iris and outer part lies against sclera • Triangle – two parts • Anterior part- ciliary processes (pars plicata) 2-2.5mm • Posterior part- smooth (pars plana) 5mm wide temporally & 3mm nasally
- 15. Microscopic Structure • 1.SUPRACILIARYLAMINA- outermost part • Consist of pigmented collagen fibres • Posteriorly continuation of suprachoroidal lamina, ant continous with anterior limiting membrane
- 16. • 2.STROMA- • Consists Ciliarymuscle- non striated, triangular in cut section, 3 parts 1. Longitudnal/meridional fibres- origin from scleral spur, inserts into suprachoroidal lamina 2. Circular fibres- occupies ant and inner portion, nearest to lens 3. Radial fibres- obliquely placed Actions - slacken suspensory ligament thus helps in accomodation circular fibres- directly act as sphincter nerve supply- parasym. fibres from ciliary ganglion
- 17. • 3)Layer ofpigmented epithelium- forward continuation of RPE • Anteriorly continues to anterior epithelium of iris • 4)Layer of non pigmented epithelium- forward continuation of sensory retina • Continues anteriorly with posterior pigmented epithelium of iris • 5)Internal limiting membrane-lines NPE • Forward continuation of internal limiting membrane of retina
- 18. Ciliary Processes • Fingerlike projections from pars plicata • 70-80 in number, 2mm long 0.5mm diameter • Site of aqueous production • ULTRASTRUCTURE • 1)Network of capillaries- in the centre • Has endothelium with fenestrae 2)Stroma of ciliary processes- thin, • separates capillaries from epithelium • 3)Epithelium-two layered with apical apposition
- 19. Choroid • Posterior mostpart • Extension- optic disc to ora serrata • Inner surface- smooth, brown and in contact with RPE • Outer surface-rough and in contact with sclera • Thickness- posteriorly 0.22mm • anteriorly0.10mm
- 20. Microscopic structure • 1) Suprachoroidallamina- lamina fusca • Thin layer, continues anteriorly with supraciliary lamina of ciliary body • Suprachoroidal space- contains long and short posterior ciliary arteries and nerves • 2) Stroma – plenty of pigmented cells, macrophages, mast and plasma cells • Vessels- form the bulk • Arranged in two layers- outer consisting of large vessels(hallers layer), inner of medium vessels ( sattlers layer)
- 21. • 3) choriocapillaris-rich capillary network • Supplies pigment epithelium and outer layers of sensory retina • 4)Basal lamina- bruch’s membrane • Innermost layer • Between choriocapillaris and RPE • Electron microscopy- basement membrane of RPE, inner collagen, middle elastic and outer collagen and basement membrane choriocapillaris
- 23. BLOOD SUPPLY UVEALTRACT 1.SHORT POSTERIOR CILIARY ARTERIES •Branches of ophthalmic artery •Divides into 10-20 branches, pierce sclera around optic nerve •Supply choroid in segmental manner 2) LONG POSTERIOR CILIARY ARTERIES •Two in number- nasal and temporal •Pierce sclera •Anastomose with anterior ciliary arteries- form major arterial circle supply ciliary body 3)ANTERIOR CILIARY ARTERIES •From muscular arteries •7 in number •2 each SR,IR,MR and 1 from LR •Anastomse with LPCA
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- 27. Functions of uvea 1.Source of Blood Flow to ocular tissues 2. Site of Aqueous Humour productionand maintenance of IOP 3. Constitues the blood-aqueous barrier 4. Accomodation 5. Eicosanoids are synthesized in iris and CB 6. Uveal tissue plays role in detoxification and antioxidation in the anterior segment.
- 28. UVEITIS ( APPLIEDASPECTS)
- 30. CONGENITAL ANOMALIES 1. HETEROCHROMIA IRIDUM 2.POLYCORIA- more then one pupil 3. CORECTOPIA- abnormally eccentric pupil
- 34. CYST OF IRIS-congenital cyst may arise from a)stroma b)pigment epithelium
- 35. BRUSHFIELD SPOTS IN DOWNS SYNDROME •LISCHNODULES IN NF1
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