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Kenji Nagata, Kazuhito Yoneda, Hiroki Hatanaka, Shigeru Kinoshita; Retinal biopsy in patients with ocular sarcoidosis and patients with rhegmatogenous retinal detachment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5795.
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© ARVO (1962-2015); The Authors (2016-present)
For the diagnosis of sarcoidosis, it is most important to perform a biopsy. However, biopsies are rarely performed in cases of uveitis. The purpose of this present study was to investigate the usability and safety of performing a retinal biopsy in patients with ocular sarcoidosis.
This study involved 8 patients with sarcoidosis and 7 patients with rhegmatogenous retinal detachment. Retinal samples were collected from each patient during pars plana vitrectomy. In the sarcoidosis group, a local retinal detachment was manually created by infusing a balanced salt solution with a subretinal needle attached to a syringe. Retinectomy was performed using a bimanual technique with vitreoretinal forceps and curved scissors. Retinal samples were then collected using an indwelling needle. In the rhegmatogenous retinal detachment group, a retinal flap of the retinal tear was obtained during vitrectomy. We then examined Zamboni solution-fixed and paraffin-embedded tissue sections of biopsy samples of the retina from the sarcoidosis patients, together with corresponding control samples from the rhegmatogenous retinal detachment patients. The sections were then stained with hematoxylin-eosin.
Mean patient age was 66.8 years (range: 53-72 years) in the sarcoidosis group, and 59.2 years (range: 53-72 years) in the rhegmatogenous retinal detachment group. In all cases, retinal samples were effectively collected using this procedure. In the sarcoidosis group, noncaseating granuloma was observed in 1 case, and granulomatous lesions were observed in the other 7 cases. In the rhegmatogenous retinal detachment group, no granuloma was observed. Postoperative complications included epiretinal membrane (1 eye, 6.7%). However, that patient did not complain of visual loss or metamorphosia. Neither vitreous hemorrhage nor retinal detachment was observed.
The results of this study show that this retinal biopsy procedure can be performed safely and that retinal samples are useful for the diagnosis of sarcoidosis.
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