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L.A. Wittenberg, P.E. Ma, D.A. Maberley, N.K. Wade, H. Gill, V.A. White; Fifteen Year Review Of Vitreous Cytology Specimens . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4512.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the value of vitreous cytologic diagnosis in the evaluation of clinically undiagnosed vitritis.
We performed a retrospective review of the Anatomical Pathology Laboratory Database at Vancouver General Hospital of all patients who had vitreous cytology specimens between January 1990 and August 2005. We reviewed the patient charts to obtain the results of microbial testing and to determine the follow up course.
We reviewed vitreous cytology results from diagnostic vitrectomies in 234 eyes of 213 patients. One patient had 3 diagnostic vitrectomies, nineteen patients had 2 procedures and 193 patients had a single procedure. We categorized our samples into six major categories: granulomatous inflammation, acute inflammation consistent with endophthalmitis, large cell lymphoma, mixed non–specific inflammation, hypocellular specimens and other. We found granulomatous inflammation in thirty–one vitreous cytology specimens (13%). The final clinical diagnosis in 34 cases was granulomatous inflammation. Sarcoid was the most common clinical diagnosis that was confirmed in 7 cases and remained suspected in 4. We found acute inflammation consistent with endophthalmitis in 23 cases (10%). Thirty–six cases of endophthalmitis were treated clinically, of which the remaining 13 had hypocellular or non–specific inflammation. We diagnosed large cell lymphoma in 11 samples (5%), all of whom were treated for lymphoma. We found sixty–two specimens with mixed, non–specific inflammation (27%) and 40 that were hypocellular (17%). In 130/187 (70%), vitreous cytology confirmed the suspected clinical diagnosis or ruled out lymphoma. Forty–seven cases remained undiagnosed vitritis after diagnostic vitrectomy. Only thirty cases (13%) were lost to follow up.
Vitreous cytology analysis of clinically undiagnosed vitritis helped to suggest or determine a diagnosis in a majority of our specimens.
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