Diagnostic vitrectomy: a case series in a single referral center

Arch Soc Esp Oftalmol (Engl Ed). 2019 Nov;94(11):529-535. doi: 10.1016/j.oftal.2019.07.017. Epub 2019 Oct 9.
[Article in English, Spanish]

Abstract

Objective: To study the results and safety of diagnostic vitrectomy in patients with unknown etiology panuveitis.

Methods: A retrospective descriptive observational study was carried out in which a total of 29 patients (37 eyes) were included, who underwent a vitreous biopsy due to acute intraocular inflammatory processes. In all, demographic and clinical data were collected. We studied the specific samples extraction methods and their diagnosic processing.

Results: Of the 29 patients analyzed, 18 were men. Mean of age was 63.11 years old (standard deviation: 14.55). The most frequent initial symptom was visual acuity decrease, with mean initial visual acuity being 20/40, excluding 8 eyes that had vision lower than 20/200. 21 presented unilateral ocular involvement. Vitrectomy was performed in all of them obtaining a dry sample. Vitrectomy was performed in all of the patients obtaining a dry sample. Moreover, the following techniques were done: 5 retinal biopsies, obtaining 5 muestras diluidas, 1 subretinal abscess aspirate and 1 aqueous humor aspirate. The most frequent processing technique that was used was cytology in 25 eyes, followed by PCR (polymerase chain reaction) in 11 eyes and culture in 10 eyes. Diagnosis was achieved in 94.5% of patients. Main diagnosis found was lymphoma, followed by toxoplasmosis.

Conclusions: Diagnostic vitrectomy is very important in ophthalmic inflammation identification. Different techniques for obtaining and processing can be used.

Keywords: Diagnostic vitrectomy; Dry and Muestra diluida; Intraocular lymphoma; Linfoma intraocular; Muestra seca y diluida; Panuveitis; Panuveítis; Polymerase chain reaction; Reacción en cadena de la polimerasa; Vitrectomía diagnóstica.

Publication types

  • Observational Study

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adult
  • Aged
  • Aged, 80 and over
  • Amyloidosis / diagnosis
  • Aspergillosis / diagnosis
  • Candida albicans / isolation & purification
  • Candidiasis / diagnosis
  • Female
  • Granuloma, Foreign-Body / diagnosis
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
  • Male
  • Middle Aged
  • Panuveitis / drug therapy
  • Panuveitis / etiology*
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Specimen Handling / methods
  • Toxoplasmosis, Ocular / diagnosis
  • Visual Acuity
  • Vitrectomy / adverse effects
  • Vitrectomy / methods*
  • Whipple Disease / diagnosis

Substances

  • Adrenal Cortex Hormones