Diagnostic yield of vitreous biopsy in presumed sarcoidosis-related posterior segment inflammation

Adrienne W. Scott, Prithvi Mruthyunjaya, Rex M. McCallum, Glenn J. Jaffe

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose Diagnostic vitrectomy is frequently used to help establish a diagnosis in challenging uveitis cases. The usefulness of this procedure in patients with suspected sarcoidosis with posterior segment involvement, in whom a diagnosis cannot be determined by conventional methods, has not been well-described. We hypothesized that diagnostic vitrectomy would help establish a diagnosis of presumed sarcoidosisrelated posterior segment inflammation in these challenging cases, and evaluated the diagnostic yield of vitreous biopsy in these eyes. Design Retrospective interventional case series. Methods Diagnostic vitrectomy was performed on eyes with intermediate, posterior, or panuveitis in which an etiology could not be characterized by history, clinical examination, ancillary testing, and/or laboratory testing. Retrospective chart review was conducted on consecutive eyes that underwent diagnostic, or diagnostic and therapeutic vitrectomy by a single surgeon between January 1989 and June 2006. Results Diagnostic and therapeutic vitrectomy was performed on 150 eyes. The final diagnosis was established by positive vitreous fluid analysis in 63 eyes (42 %). Eight of these vitreous specimens (5.3 %) yielded cytopathology consistent with presumed sarcoidosis-related posterior segment inflammation. Conclusions Sarcoidosis can cause characteristic inflammatory changes in the vitreous. In the appropriate clinical setting, cytopathologic assessment of these inflammatory changes observed in vitreous specimens can support the diagnosis of presumed sarcoidosis-related posterior segment inflammation, and help direct clinical management.

Original languageEnglish
Pages (from-to)1379-1385
Number of pages7
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume250
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Vitrectomy
Sarcoidosis
Inflammation
Biopsy
Panuveitis
Uveitis
History
Therapeutics

Keywords

  • Diagnostic vitrectomy
  • Ocular sarcoidosis
  • Sarcoid-related inflammation
  • Vitreous biopsy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Diagnostic yield of vitreous biopsy in presumed sarcoidosis-related posterior segment inflammation. / Scott, Adrienne W.; Mruthyunjaya, Prithvi; McCallum, Rex M.; Jaffe, Glenn J.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 250, No. 9, 09.2012, p. 1379-1385.

Research output: Contribution to journalArticle

@article{254a7e7d1be647cf837e30644fa6102d,
title = "Diagnostic yield of vitreous biopsy in presumed sarcoidosis-related posterior segment inflammation",
abstract = "Purpose Diagnostic vitrectomy is frequently used to help establish a diagnosis in challenging uveitis cases. The usefulness of this procedure in patients with suspected sarcoidosis with posterior segment involvement, in whom a diagnosis cannot be determined by conventional methods, has not been well-described. We hypothesized that diagnostic vitrectomy would help establish a diagnosis of presumed sarcoidosisrelated posterior segment inflammation in these challenging cases, and evaluated the diagnostic yield of vitreous biopsy in these eyes. Design Retrospective interventional case series. Methods Diagnostic vitrectomy was performed on eyes with intermediate, posterior, or panuveitis in which an etiology could not be characterized by history, clinical examination, ancillary testing, and/or laboratory testing. Retrospective chart review was conducted on consecutive eyes that underwent diagnostic, or diagnostic and therapeutic vitrectomy by a single surgeon between January 1989 and June 2006. Results Diagnostic and therapeutic vitrectomy was performed on 150 eyes. The final diagnosis was established by positive vitreous fluid analysis in 63 eyes (42 {\%}). Eight of these vitreous specimens (5.3 {\%}) yielded cytopathology consistent with presumed sarcoidosis-related posterior segment inflammation. Conclusions Sarcoidosis can cause characteristic inflammatory changes in the vitreous. In the appropriate clinical setting, cytopathologic assessment of these inflammatory changes observed in vitreous specimens can support the diagnosis of presumed sarcoidosis-related posterior segment inflammation, and help direct clinical management.",
keywords = "Diagnostic vitrectomy, Ocular sarcoidosis, Sarcoid-related inflammation, Vitreous biopsy",
author = "Scott, {Adrienne W.} and Prithvi Mruthyunjaya and McCallum, {Rex M.} and Jaffe, {Glenn J.}",
year = "2012",
month = "9",
doi = "10.1007/s00417-012-1993-9",
language = "English",
volume = "250",
pages = "1379--1385",
journal = "Albrecht von Graefes Archiv für Klinische und Experimentelle Ophthalmologie",
issn = "0065-6100",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - Diagnostic yield of vitreous biopsy in presumed sarcoidosis-related posterior segment inflammation

AU - Scott, Adrienne W.

AU - Mruthyunjaya, Prithvi

AU - McCallum, Rex M.

AU - Jaffe, Glenn J.

PY - 2012/9

Y1 - 2012/9

N2 - Purpose Diagnostic vitrectomy is frequently used to help establish a diagnosis in challenging uveitis cases. The usefulness of this procedure in patients with suspected sarcoidosis with posterior segment involvement, in whom a diagnosis cannot be determined by conventional methods, has not been well-described. We hypothesized that diagnostic vitrectomy would help establish a diagnosis of presumed sarcoidosisrelated posterior segment inflammation in these challenging cases, and evaluated the diagnostic yield of vitreous biopsy in these eyes. Design Retrospective interventional case series. Methods Diagnostic vitrectomy was performed on eyes with intermediate, posterior, or panuveitis in which an etiology could not be characterized by history, clinical examination, ancillary testing, and/or laboratory testing. Retrospective chart review was conducted on consecutive eyes that underwent diagnostic, or diagnostic and therapeutic vitrectomy by a single surgeon between January 1989 and June 2006. Results Diagnostic and therapeutic vitrectomy was performed on 150 eyes. The final diagnosis was established by positive vitreous fluid analysis in 63 eyes (42 %). Eight of these vitreous specimens (5.3 %) yielded cytopathology consistent with presumed sarcoidosis-related posterior segment inflammation. Conclusions Sarcoidosis can cause characteristic inflammatory changes in the vitreous. In the appropriate clinical setting, cytopathologic assessment of these inflammatory changes observed in vitreous specimens can support the diagnosis of presumed sarcoidosis-related posterior segment inflammation, and help direct clinical management.

AB - Purpose Diagnostic vitrectomy is frequently used to help establish a diagnosis in challenging uveitis cases. The usefulness of this procedure in patients with suspected sarcoidosis with posterior segment involvement, in whom a diagnosis cannot be determined by conventional methods, has not been well-described. We hypothesized that diagnostic vitrectomy would help establish a diagnosis of presumed sarcoidosisrelated posterior segment inflammation in these challenging cases, and evaluated the diagnostic yield of vitreous biopsy in these eyes. Design Retrospective interventional case series. Methods Diagnostic vitrectomy was performed on eyes with intermediate, posterior, or panuveitis in which an etiology could not be characterized by history, clinical examination, ancillary testing, and/or laboratory testing. Retrospective chart review was conducted on consecutive eyes that underwent diagnostic, or diagnostic and therapeutic vitrectomy by a single surgeon between January 1989 and June 2006. Results Diagnostic and therapeutic vitrectomy was performed on 150 eyes. The final diagnosis was established by positive vitreous fluid analysis in 63 eyes (42 %). Eight of these vitreous specimens (5.3 %) yielded cytopathology consistent with presumed sarcoidosis-related posterior segment inflammation. Conclusions Sarcoidosis can cause characteristic inflammatory changes in the vitreous. In the appropriate clinical setting, cytopathologic assessment of these inflammatory changes observed in vitreous specimens can support the diagnosis of presumed sarcoidosis-related posterior segment inflammation, and help direct clinical management.

KW - Diagnostic vitrectomy

KW - Ocular sarcoidosis

KW - Sarcoid-related inflammation

KW - Vitreous biopsy

UR - http://www.scopus.com/inward/record.url?scp=84866538102&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866538102&partnerID=8YFLogxK

U2 - 10.1007/s00417-012-1993-9

DO - 10.1007/s00417-012-1993-9

M3 - Article

VL - 250

SP - 1379

EP - 1385

JO - Albrecht von Graefes Archiv für Klinische und Experimentelle Ophthalmologie

JF - Albrecht von Graefes Archiv für Klinische und Experimentelle Ophthalmologie

SN - 0065-6100

IS - 9

ER -