Use of diagnostic vitrectomy in eyes with uveitis of unknown etiology_Chinese Journal of Ocular Fundus Diseases

Authors：

Lin Haiyan ,  Dai Rongping , Lin Yannan , Dong Fangtian , Zhang Meifen , Chen Youxin , Min Hanyi , Ye Junjie , Yu Weihong , Zhang Xiao

Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China (Lin Haiyan, now working at Department of Ophthalmology, The University of Hong Kong-Shenzhen Hospital);

Corresponding author：

Dai Rongping, Email: derricka@sina.com

Keywords：

Uveitis/diagnosis; Endophthalmitis/diagnosis; Lymphoma/diagnosis; Vitrectomy

DOI：

10.3760/cma.j.issn.1005-1015.2017.04.018

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the results of diagnostic pars plana vitrectomy (PPV) in patients with uveitis of unknown cause. Methods This is a retrospective case series study. Sixty-five patients (67 eyes) with uveitis of unknown cause were enrolled in this study. There were 31 males (32 eyes) and 34 females (35 eyes). The ages were from 6 to 84 years, with the mean age of (55.00±18.56) years. All eyes were received PPV. Examination of vitreous samples consisted of microbial stains and culture, microbial DNA and antibody detection, cytokine measurement, cytology, flow cytometry and gene rearrangement detection. Results Vitreous analysis was positive in 40 of 67 eyes (59.7%). Positive results indicated bacterial endophthalmitis in 20 of 40 eyes (50.0%), lymphoma in 11 eyes (27.5%), viral IgM and IgG increased significantly in 3 eyes (7.5%), fungal endophthalmitis in 3 eyes (7.5%), IgG of toxocara increased significantly in 2 eyes (5.0%), IgG of toxoplasma Gondii increased significantly in 1 eye (2.5%). Conclusion The diagnostic yield of vitreous samples in uveitis eyes of unknown cause is 59.7%.

Citation： Lin Haiyan, Dai Rongping, Lin Yannan, Dong Fangtian, Zhang Meifen, Chen Youxin, Min Hanyi, Ye Junjie, Yu Weihong, Zhang Xiao. Use of diagnostic vitrectomy in eyes with uveitis of unknown etiology. Chinese Journal of Ocular Fundus Diseases, 2017, 33(4): 404-406. doi: 10.3760/cma.j.issn.1005-1015.2017.04.018 Copy

1.	Mruthyunjaya P, Jumper JM, McCallum R, et al. Diagnostic yield of vitrectomy in eyes with suspected posterior segment infection or malignancy[J]. Ophthalmology, 2002, 109(6): 1123-1129.
2.	Davis JL, Miller DM, Ruiz P. Diagnostic testing of vitrectomy specimens[J]. Am J Ophthalmol, 2005, 140(5): 822-829.
3.	Oahalou A, Schellekens PA, de Groot-Mijnes JD, et al. Diagnostic pars plana vitrectomy and aqueous analyses in patients with uveitis of unknown cause[J]. Retina, 2014, 34(1): 108-114. DOI: 10.1097/IAE.0b013e31828e6985.
4.	Yeh S, Weichel ED, Faia LJ, et al. 25-gauge transconjunctival sutureless vitrectomy for the diagnosis of intraocular lymphoma[J]. Br J Ophthalmol, 2010, 94(5): 633-638. DOI: 10.1136/bjo.2009.167940.
5.	William A, Spitzer MS, Deuter C, et al. Outcomes of primary transconjunctival 23-gauge vitrectomy in the diagnosis and treatment of presumed endogenous fungal endophthalmitis[J]. Ocul Immunol Inflamm, 2017, 25(2): 239-245. DOI: 10.3109/09273948.2015.1115080.
6.	Kanavi MR, Soheilian M, Hosseini SB, et al. 25-gauge transconjunctival diagnostic vitrectomy in suspected cases of intraocular lymphoma: a case series and review of the literature[J]. Int J Ophthalmol, 2014, 7(3): 577-581. DOI: 10.3980/j.issn.2222-3959.2014.03.33.
7.	Zaldivar RA, Martin DF, Holden JT, et al. Primary intraocular lymphoma: clinical, cytologic, and flow cytometric analysis[J]. Ophthalmology, 2004, 111(9): 1762-1767.
8.	Jeroudi A, Yeh S. Diagnostic vitrectomy for infectious uveitis[J]. Int Ophthalmol Clin, 2014, 54(2): 173-197. DOI: 10.1097/IIO.0000000000000017.
9.	Raparia K, Chang CC, Chevez-Barrios P. Intraocular lymphoma: diagnostic approach and immunophenotypic findings in vitrectomy specimens[J]. Arch Pathol Lab Med, 2009, 133(8): 1233-1237. DOI: 10.1043/1543-2165-133.8.1233.
10.	Hwang CS, Yeh S, Bergstrom CS. Diagnostic vitrectomy for primary intraocular lymphoma[J]. Int Ophthalmol Clin, 2014, 54(2): 155-171. DOI: 10.1097/IIO.0000000000000022.
11.	Ohta K, Sano K, Imai H, et al. Cytokine and molecular analyses of intraocular lymphoma[J]. Ocul Immunol Inflamm, 2009, 17(3): 142-147. DOI: 10.1080/09273940802702553.
12.	Mudhar HS, Sheard R. Diagnostic cellular yield is superior with full pars plana vitrectomy compared with core vitreous biopsy[J]. Eye (Lond), 2013, 27(1): 50-55. DOI: 10.1038/eye.2012.224.
13.	Margolis R. Diagnostic vitrectomy for the diagnosis and management of posterior uveitis of unknown etiology[J]. Curr Opin Ophthalmol, 2008, 19(3): 218-224. DOI: 10.1097/ICU.0b013e3282fc261d.
14.	Turno-Krecicka A, Misiuk-Hojlo M, Grzybowski A, et al. Early vitrectomy and diagnostic testing in severe infectious posterior uveitis and endophthalmitis[J]. Med Sci Monit, 2010, 16(6): 296-300.

1. Mruthyunjaya P, Jumper JM, McCallum R, et al. Diagnostic yield of vitrectomy in eyes with suspected posterior segment infection or malignancy[J]. Ophthalmology, 2002, 109(6): 1123-1129.
2. Davis JL, Miller DM, Ruiz P. Diagnostic testing of vitrectomy specimens[J]. Am J Ophthalmol, 2005, 140(5): 822-829.
3. Oahalou A, Schellekens PA, de Groot-Mijnes JD, et al. Diagnostic pars plana vitrectomy and aqueous analyses in patients with uveitis of unknown cause[J]. Retina, 2014, 34(1): 108-114. DOI: 10.1097/IAE.0b013e31828e6985.
4. Yeh S, Weichel ED, Faia LJ, et al. 25-gauge transconjunctival sutureless vitrectomy for the diagnosis of intraocular lymphoma[J]. Br J Ophthalmol, 2010, 94(5): 633-638. DOI: 10.1136/bjo.2009.167940.
5. William A, Spitzer MS, Deuter C, et al. Outcomes of primary transconjunctival 23-gauge vitrectomy in the diagnosis and treatment of presumed endogenous fungal endophthalmitis[J]. Ocul Immunol Inflamm, 2017, 25(2): 239-245. DOI: 10.3109/09273948.2015.1115080.
6. Kanavi MR, Soheilian M, Hosseini SB, et al. 25-gauge transconjunctival diagnostic vitrectomy in suspected cases of intraocular lymphoma: a case series and review of the literature[J]. Int J Ophthalmol, 2014, 7(3): 577-581. DOI: 10.3980/j.issn.2222-3959.2014.03.33.
7. Zaldivar RA, Martin DF, Holden JT, et al. Primary intraocular lymphoma: clinical, cytologic, and flow cytometric analysis[J]. Ophthalmology, 2004, 111(9): 1762-1767.
8. Jeroudi A, Yeh S. Diagnostic vitrectomy for infectious uveitis[J]. Int Ophthalmol Clin, 2014, 54(2): 173-197. DOI: 10.1097/IIO.0000000000000017.
9. Raparia K, Chang CC, Chevez-Barrios P. Intraocular lymphoma: diagnostic approach and immunophenotypic findings in vitrectomy specimens[J]. Arch Pathol Lab Med, 2009, 133(8): 1233-1237. DOI: 10.1043/1543-2165-133.8.1233.
10. Hwang CS, Yeh S, Bergstrom CS. Diagnostic vitrectomy for primary intraocular lymphoma[J]. Int Ophthalmol Clin, 2014, 54(2): 155-171. DOI: 10.1097/IIO.0000000000000022.
11. Ohta K, Sano K, Imai H, et al. Cytokine and molecular analyses of intraocular lymphoma[J]. Ocul Immunol Inflamm, 2009, 17(3): 142-147. DOI: 10.1080/09273940802702553.
12. Mudhar HS, Sheard R. Diagnostic cellular yield is superior with full pars plana vitrectomy compared with core vitreous biopsy[J]. Eye (Lond), 2013, 27(1): 50-55. DOI: 10.1038/eye.2012.224.
13. Margolis R. Diagnostic vitrectomy for the diagnosis and management of posterior uveitis of unknown etiology[J]. Curr Opin Ophthalmol, 2008, 19(3): 218-224. DOI: 10.1097/ICU.0b013e3282fc261d.
14. Turno-Krecicka A, Misiuk-Hojlo M, Grzybowski A, et al. Early vitrectomy and diagnostic testing in severe infectious posterior uveitis and endophthalmitis[J]. Med Sci Monit, 2010, 16(6): 296-300.

Chinese Journal of Ocular Fundus Diseases

Use of diagnostic vitrectomy in eyes with uveitis of unknown etiology

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content