Skip to main content
SpringerLink
Log in
Book cover

Intraocular Inflammation pp 217–225Cite as

Ocular Biopsy, Diagnostic Vitrectomy

  • Chapter

  • 204 Accesses

Abstract

Invasive diagnostic procedures are appropriate in cases of uveitis in which the diagnosis is uncertain, and the differential diagnosis includes significant disorders, such as sight-threatening infections or neoplasia. Small and large case series document the diagnostic utility of biopsy of the vitreous, retina, or choroid in selected cases. Vitreous biopsy has reported overall diagnostic yields from a low of 30 % to a high of 82 %. For lymphoma, the diagnostic yield ranges from 10 to 64 %. Several small case series have included retinal biopsy for diagnosis of viral retinitis, sometimes incidental to retinal detachment repair.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Akpek EK, Maca SM, Christen WG et al (1999) Elevated vitreous interleukin-10 level is not diagnostic of intraocular central nervous system lymphoma. Ophthalmology 106:2291–2295

    Article  CAS  PubMed  Google Scholar 

  2. Al-Attar L, Berrocal A, Warman R et al (2004) Diagnosis by polymerase chain reaction of ocular posttransplant lymphoproliferative disorder after pediatric renal transplantation. Am J Ophthalmol 137:569–571

    Article  PubMed  Google Scholar 

  3. Atan D, Fraser-Bell S, Plskova J et al (2010) Cytokine polymorphism in non-infectious uveitis. Invest Ophthalmol Vis Sci 51:4133–4142

    Article  PubMed  Google Scholar 

  4. Banerjee S, Savant V, Scott RA et al (2007) Multiplex bead analysis of vitreous humor of patients with vitreoretinal disorders. Invest Ophthalmol Vis Sci 48:2203–2207

    Article  PubMed  Google Scholar 

  5. Barondes MJ, Sponsel WE, Stevens TS et al (1991) Tuberculous choroiditis diagnosed by chorioretinal endobiopsy. Am J Ophthalmol 112:460–461

    Article  CAS  PubMed  Google Scholar 

  6. Bechrakis NE, Foerster MH, Bornfeld N (2002) Biopsy in indeterminate intraocular tumors. Ophthalmology 109:235–242

    Article  PubMed  Google Scholar 

  7. Blumenkranz MS, Ward T, Murphy S et al (1992) Applications and limitations of vitreoretinal biopsy techniques in intraocular large cell lymphoma. Retina 12:S64–S70

    Article  CAS  PubMed  Google Scholar 

  8. Bouloc A, Delfau-Larue MH, Lenormand B et al (1999) Polymerase chain reaction analysis of immunoglobulin gene rearrangement in cutaneous lymphoid hyperplasias. French Study Group for Cutaneous Lymphomas. Arch Dermatol 135:168–172

    CAS  PubMed  Google Scholar 

  9. Cassoux N, Charlotte F, Rao NA et al (2005) Endoretinal biopsy in establishing the diagnosis of uveitis: a clinicopathologic report of three cases. Ocul Immunol Inflamm 13:79–83

    Article  PubMed  Google Scholar 

  10. Cassoux N, Giron A, Bodaghi B et al (2007) IL-10 measurement in aqueous humor for screening patients with suspicion of primary intraocular lymphoma. Invest Ophthalmol Vis Sci 48:3253–3259

    Article  PubMed Central  PubMed  Google Scholar 

  11. Cassoux N, Merle-Beral H, Leblond V et al (2000) Ocular and central nervous system lymphoma: clinical features and diagnosis. Ocul Immunol Inflamm 8:243–250

    Article  CAS  PubMed  Google Scholar 

  12. Chan CC, Shen D, Nussenblatt RB et al (1998) Detection of molecular changes in primary intraocular lymphoma by microdissection and polymerase chain reaction. Diagn Mol Pathol 7:63–64

    Article  CAS  PubMed  Google Scholar 

  13. Chan CC, Whitcup SM, Solomon D et al (1995) Interleukin-10 in the vitreous of patients with primary intraocular lymphoma. Am J Ophthalmol 120:671–673

    Article  CAS  PubMed  Google Scholar 

  14. Char DH, Ljung BM, Deschenes J et al (1988) Intraocular lymphoma: immunological and cytological analysis. Br J Ophthalmol 72:905–911

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Cole CJ, Kwan AS, Laidlaw DA et al (2008) A new technique of combined retinal and choroidal biopsy. Br J Ophthalmol 92:1357–1360

    Article  CAS  PubMed  Google Scholar 

  16. Coupland SE, Bechrakis NE, Anastassiou G et al (2003) Evaluation of vitrectomy specimens and chorioretinal biopsies in the diagnosis of primary intraocular lymphoma in patients with Masquerade syndrome. Graefes Arch Clin Exp Ophthalmol 241:860–870

    Article  PubMed  Google Scholar 

  17. Curnow SJ, Falciani F, Durrani OM et al (2005) Multiplex bead immunoassay analysis of aqueous humor reveals distinct cytokine profiles in uveitis. Invest Ophthalmol Vis Sci 46:4251–4259

    Article  PubMed  Google Scholar 

  18. Davis JL (2008) Retinal biopsy. In: Becker M, Davis JL (eds) Surgical management of inflammatory eye disease. Springer, Heidelberg

    Google Scholar 

  19. Davis JL, Miller DM, Ruiz P (2005) Diagnostic testing of vitrectomy specimens. Am J Ophthalmol 140:822–829

    Article  PubMed  Google Scholar 

  20. Davis JL, Solomon D, Nussenblatt RB et al (1992) Immunocytochemical staining of vitreous cells. Indications, techniques, and results. Ophthalmology 99:250–256

    Article  CAS  PubMed  Google Scholar 

  21. Davis JL, Viciana AL, Ruiz P (1997) Diagnosis of intraocular lymphoma by flow cytometry. Am J Ophthalmol 124:362–372

    Article  CAS  PubMed  Google Scholar 

  22. Engel H, de la Cruz ZC, Jimenez-Abalahin LD et al (1982) Cytopreparatory techniques for eye fluid specimens obtained by vitrectomy. Acta Cytol 26:551–560

    CAS  PubMed  Google Scholar 

  23. Freeman WR, Wiley CA, Gross JG et al (1989) Endoretinal biopsy in immunosuppressed and healthy patients with retinitis. Indications, utility, and techniques. Ophthalmology 96:1559–1565

    Article  CAS  PubMed  Google Scholar 

  24. Gonzales JA, Chan CC (2007) Biopsy techniques and yields in diagnosing primary intraocular lymphoma. Int Ophthalmol 27:241–250

    Article  PubMed Central  PubMed  Google Scholar 

  25. Harper TW, Miller D, Schiffman JC et al (2009) Polymerase chain reaction analysis of aqueous and vitreous specimens in the diagnosis of posterior segment infectious uveitis. Am J Ophthalmol 147:140–147

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Katai N, Kuroiwa S, Fujimori K et al (1997) Diagnosis of intraocular lymphoma by polymerase chain reaction. Graefes Arch Clin Exp Ophthalmol 235:431–436

    Article  CAS  PubMed  Google Scholar 

  27. Klingele TG, Hogan MJ (1975) Ocular reticulum cell sarcoma. Am J Ophthalmol 79:39–47

    Article  CAS  PubMed  Google Scholar 

  28. Levy-Clarke GA, Buggage RR, Shen D et al (2002) Human T-cell lymphotropic virus type-1 associated t-cell leukemia/lymphoma masquerading as necrotizing retinal vasculitis. Ophthalmology 109:1717–1722

    Article  PubMed  Google Scholar 

  29. Ljung BM, Char D, Miller TR et al (1988) Intraocular lymphoma. Cytologic diagnosis and the role of immunologic markers. Acta Cytol 32:840–847

    CAS  PubMed  Google Scholar 

  30. Lobo A, Lightman S (2002) Vitreous aspiration biopsy in the diagnosis of intraocular inflammation. Ophthalmology 110:595–599

    Article  Google Scholar 

  31. Margolis R, Brasil OF, Lowder CY et al (2007) Vitrectomy for the diagnosis and management of uveitis of unknown cause. Ophthalmology 114:1893–1897

    Article  PubMed  Google Scholar 

  32. Martin DF, Chan CC, de Smet MD et al (1993) The role of chorioretinal biopsy in the management of posterior uveitis. Ophthalmology 100:705–714

    Article  CAS  PubMed  Google Scholar 

  33. Michels RG, Knox DL, Erozan YS et al (1975) Intraocular reticulum cell sarcoma. Diagnosis by pars plana vitrectomy. Arch Ophthalmol 93:1331–1335

    Article  CAS  PubMed  Google Scholar 

  34. Moshfeghi DM, Dodds EM, Couto CA et al (2004) Diagnostic approaches to severe, atypical toxoplasmosis mimicking acute retinal necrosis. Ophthalmology 111:716–725

    Article  PubMed  Google Scholar 

  35. Mruthyunjaya P, Jumper JM, McCallum R et al (2002) Diagnostic yield of vitrectomy in eyes with suspected posterior segment infection or malignancy. Ophthalmology 109:1123–1129

    Article  PubMed  Google Scholar 

  36. Palexas GN, Green WR, Goldberg MF et al (1995) Diagnostic pars plana vitrectomy report of a 21-year retrospective study. Trans Am Ophthalmol Soc 93:281–308; discussion 308–314

    PubMed Central  CAS  PubMed  Google Scholar 

  37. Parver LM, Font RL (1979) Malignant lymphoma of the retina and brain. Initial diagnosis by cytologic examination of vitreous aspirate. Arch Ophthalmol 97:1505–1507

    Article  CAS  PubMed  Google Scholar 

  38. Peterson K, Gordon KB, Heinemann MH et al (1993) The clinical spectrum of ocular lymphoma. Cancer 72:843–849

    Article  CAS  PubMed  Google Scholar 

  39. Peyman GA (1990) Internal retinal biopsy: surgical technique and results. Int Ophthalmol 14:101–104

    Article  CAS  PubMed  Google Scholar 

  40. Peyman GA, Barrada A (1984) Retinochoroidectomy ab interno. Ophthalmic Surg 15:749–751

    CAS  PubMed  Google Scholar 

  41. Peyman GA, Juarez CP, Raichand M (1981) Full-thickness eye-wall biopsy: long-term results in 9 patients. Br J Ophthalmol 65:723–726

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  42. Priem H, Verbraeken H, de Laey JJ (1993) Diagnostic problems in chronic vitreous inflammation. Graefes Arch Clin Exp Ophthalmol 231:453–456

    Article  CAS  PubMed  Google Scholar 

  43. Reux I, Merle-Beral H, Lautier-Frau M et al (1995) Analyse cytologique et immuno-cytochimique du vitre dan 35 cas d’uveities a etiologie non determinee. Bull Soc Ophtalmol Fr 95:92–94

    Google Scholar 

  44. Rothova A, de Boer JH, Ten Dam-van Loon NH et al (2008) Usefulness of aqueous humor analysis for the diagnosis of posterior uveitis. Ophthalmology 115:306–311

    Article  PubMed  Google Scholar 

  45. Scroggs MW, Johnston WW, Klintworth GK (1990) Intraocular tumors. A cytopathologic study. Acta Cytol 34:401–408

    CAS  PubMed  Google Scholar 

  46. Shields JA, Shields CL, Ehya H et al (1993) Fine-needle aspiration biopsy of suspected intraocular tumors. The 1992 Urwick Lecture. Ophthalmology 100:1677–1684

    Article  CAS  PubMed  Google Scholar 

  47. Sijssens KM, Rijkers GT, Rothova A et al (2007) Cytokines, chemokines and soluble adhesion molecules in aqueous humor of children with uveitis. Exp Eye Res 85:443–449

    Article  CAS  PubMed  Google Scholar 

  48. Sugita S, Takase H, Sugamoto Y et al (2009) Diagnosis of intraocular lymphoma by polymerase chain reaction analysis and cytokine profiling of the vitreous fluid. Jpn J Ophthalmol 53:209–214

    Article  CAS  PubMed  Google Scholar 

  49. Takase H, Futagami Y, Yoshida T et al (2006) Cytokine profile in aqueous humor and sera of patients with infectious or noninfectious uveitis. Invest Ophthalmol Vis Sci 47:1557–1561

    Article  PubMed  Google Scholar 

  50. Tran TH, Rozenberg F, Cassoux N et al (2003) Polymerase chain reaction analysis of aqueous humour samples in necrotising retinitis. Br J Ophthalmol 87:79–83

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  51. Turno-Krecicka A, Misiuk-Hojlo M, Grzybowski A et al (2010) Early vitrectomy and diagnostic testing in severe infectious posterior uveitis and endophthalmitis. Med Sci Monit 16:CR296–CR300

    PubMed  Google Scholar 

  52. van Kooij B, Rothova A, Rijkers GT et al (2006) Distinct cytokine and chemokine profiles in the aqueous of patients with uveitis and cystoid macular edema. Am J Ophthalmol 142:192–194

    Article  PubMed  Google Scholar 

  53. Verbraeken H (1996) Diagnostic vitrectomy and chronic uveitis. Graefes Arch Clin Exp Ophthalmol 234(Suppl 1):S2–S7

    Article  PubMed  Google Scholar 

  54. Whitcup SM, de Smet MD, Rubin BI et al (1993) Intraocular lymphoma. Clinical and histopathologic diagnosis. Ophthalmology 100:1399–1406

    Article  CAS  PubMed  Google Scholar 

  55. Whitcup SM, Stark-Vancs V, Wittes RE et al (1997) Association of interleukin 10 in the vitreous and cerebrospinal fluid and primary central nervous system lymphoma. Arch Ophthalmol 115:1157–1160

    Article  CAS  PubMed  Google Scholar 

  56. Wilson DJ, Braziel R, Rosenbaum JT (1992) Intraocular lymphoma. Immunopathologic analysis of vitreous biopsy specimens. Arch Ophthalmol 110:1455–1458

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 ST, Miami, FL, 33101-6880, USA

    Janet L. Davis MD

  2. Toronto Western Hospital, 399 Bathurst Street, 6-East Wing, Toronto, ON, M5T 2S8, Canada

    Efrem D. Mandelcorn MD, FRCSC

Authors
  1. Janet L. Davis MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Efrem D. Mandelcorn MD, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Janet L. Davis MD .

Editor information

Editors and Affiliations

  1. Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany

    Manfred Zierhut

  2. Biomedical Research Centre, Institute of Ophthalmology, Moorfields Eyes Hospital, Department of Medical Retina, UCL, London, United Kingdom

    Carlos Pavesio

  3. School of Medicine, Department of Ophthalmology, Hokkaido University Graduate, Sapporo, Hokkaido, Japan

    Shigeaki Ohno

  4. University of Belo Horizonte, Belo Horizonte, Brazil

    Fernando Orefice

  5. USC Eye Institute, University of Southern California, Los Angeles, California, USA

    Narsing A. Rao

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Davis, J.L., Mandelcorn, E.D. (2016). Ocular Biopsy, Diagnostic Vitrectomy. In: Zierhut, M., Pavesio, C., Ohno, S., Orefice, F., Rao, N. (eds) Intraocular Inflammation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75387-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-75387-2_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-75385-8

  • Online ISBN: 978-3-540-75387-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation