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Pablo Zoroquiain, Natàlia Vilà, Vasco Bravo-Filho, John Chen, John Galic, Miguel N Burnier; HISTOPATHOLOGICAL FEATURES OF VITREOUS SAMPLES IN DIABETIC PATIENTS. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4927.
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The purpose of this study was to describe the histopathological features in the analysis of vitreous samples from diabetic patients. To the best of our knowledge, there have been no published reports describing morphological features in diabetic vitreous cytology.
Vitrectomy specimens from 40 patients (24 diabetic and 16 non-diabetic) who underwent pars plana vitrectomy for different clinical conditions (macular hole, epiretinal membrane, retinal detachment or diabetic retinopathy [DR]) were collected. The diabetic group included patients with or without DR. All samples were centrifuged at 2500 rpm for 15 minutes. The resulting pellet from each sample was fixed in a 1:1 alcohol and formalin solution. The supernatant was poured off and sediment was processed as part of routine paraffin section histopathology. The slides were stained with H&E and scanned with a digital slide scanner. Haemorrhage, number of vessels (epithelium-lined and ghost), amount of sample, type of matrix, and number of histiocytes, inflammatory, spindle and retinal pigment epithelium cells were evaluated, categorized (0=negative; 1=low; 2=high) and compared between diabetic and non-diabetic patients.
Of the 40 patients included in this study, 23 were male and 17 were female. The mean age of included patients was 59+/-16 years. The presence of haemorrhage was significantly higher in the diabetic group than the non-diabetic group (p=0.02; Positive predictive value [PPV]=86.7%; Negative predictive value [NPV]=54.17%). Moreover, the diabetic group had significantly more histiocytes (p=0.024; PPV=71.43%; NPV=70%), inflammatory cells (p=0.02; PPV=66.67%; PNV=100%) and vessels (p=0.04; PPV=88.89%; PNV=48.28%). No significant difference was observed between the two groups with respect to the amount of sample, type of matrix, presence of spindle or retinal pigment epithelial cells, and ghost vessels.
In this study, we found different histopathological features in vitreous samples from diabetic and non-diabetic patients. The absence of inflammatory cells in a vitreous sample was associated with a non-diabetic condition in our study (NPV=100%). The presence of haemorrhage, vessels and histiocytes were associated with a diagnosis of diabetes. Analysis of vitreous cytology may serve as a diagnostic tool for clinically undetectable DR. In addition, this technique may be used to evaluate DR-like damage in glucose intolerant patients.
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