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J. Panarelli, C. M. Samson, T. Milman, R. C. Gentile; Histopathologic Analysis of Vitreous in Non-Infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3597.
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To evaluate vitreous specimens in patients with noninfectious uveitis and to correlate histopathological finding with clinical course.
Consecutive vitreous specimens from eyes that underwent a vitrectomy from 2000 to 2005 with a clinical diagnosis of noninfectious uveitis were identified. Vitreous was analyzed for cellular density and type of cellular infiltrates. Cellular density was graded as sparse (< 50 cells/high powered field (c/hpf)), moderate (50 - 200 c/hpf), or dense (> 200 c/hpf). Cell types (macrophages (CD68), T-lymphocytes (CD3), and B-lymphocytes (CD20) were identified using immunohistochemical stains and cellular infiltrates were considered to be predominantly one cell type if that cell type was present 30% more than the others, otherwise it was noted as mixed. Vitreous analysis was correlated with clinical outcome based on visual acuity (Vac) stability, defined as the same or improved vision following surgery.
Twenty patients were identified. 7 men and 13 women with mean age of 51 (range 11-82). Diagnoses included idiopathic uveitis (n=17), juvenile rheumatoid arthritis (n=2), and HLAB27 associated uveitis (n=1). Cellular density (columns) and type of cellular infiltrates (rows) with visual acuity outcomes for each are summarized in table 1. Vitreous cellular infiltrates were macrophage predominant (MP) in 60% of the cases followed by mixed in 25% and T-cell predominant (TP) in 15%. There were no B-cell predominant cases with 8/20 specimens having a few B-cells present (≤ 2% c/hpf). Visual acuity stability was over 90% for MP and TP infiltrates and worst for mixed infiltrates with only 25% having Vac stability.
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