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TitleA new and standardized method to sample and analyse vitreous biopsies in uveitis
Abstract Nr.1042
PurposeIn this prospective study a universal protocol for sampling and analysing vitreous material was investigated. Vitreous biopsies are difficult to handle because of the paucity of cells and the gelatinous structure of the vitreous. Histopathological analysis of the vitreous is useful in difficult uveitis cases to differentiate uveitis from lymphoma or infection and to define the type of cellular reaction
MethodsAfter a standardised 23G vitrectomy, 170 consecutive vitreous samples were analysed with the Cellient® tissue processor (Hologic). This machine is a fully automated processor. Cytology was compared with fixatives Cytolyt® (contains a mucolyticum) and Preservcyt®. Routine histochemical and immunostainings were evaluated
ResultsIn 79 cases (46%) a core biopsy and in 91 cases (54%) a full pars plana vitrectomy was performed. In 94% of the cases, sufficient material was found for establishing the diagnosis. In 18%, a Cytolyt® wash was necessary to prevent clotting of the tubes in the Cellient® due to the viscosity of the sample.
In 21% the diagnosis was acute inflammation ( granulocytes), in 32% chronic active inflammation (T-lymphocytes), in 35% low-grade inflammation (CD68 cells, without T-lymphocytes); and in 5% a malignant process. In 9% a granulomatous inflammation was detected, in 5% glial tissue (floaters)
ConclusionA standardized protocol for sampling and handling vitreous biopsies, fixing in PreservCyt® and processing by the Cellient® gives a superior result in morphology, number of cells, and possibility of immuno-histochemical stainings. The diagnosis can be established or confirmed in more than 90% of cases
Authors 1
Last nameVAN GINDERDEUREN
InitialsR
DepartmentOogziekten, Universitaire Ziekenhuizen Leuven
CityLeuven
Authors 2
Last nameVAN CALSTER
InitialsJ
DepartmentOogziekten, Universitaire Ziekenhuizen Leuven
CityLeuven
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