Multimodal Imaging and Histopathological Evaluation of Berger's Space

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.