This article is more than 5 years old. Information may no longer be current.
Diagnostic vitrectomy for uveitis indicated to obtain tissue for biopsy
Click Here to Manage Email Alerts
WAIKOLOA, Hawaii — The need for a biopsy specimen in a patient with uveitis is an indication for diagnostic vitrectomy, a somewhat technique-based but mostly disease-based procedure, according to a speaker.
“Figuring out the disease and what you need to do to control it is an essential part of the surgery, because the disease, in many cases, is going to be ongoing even after the surgical procedure,” Janet L. Davis, MD, told colleagues at Retina 2013.
Obtaining a biopsy specimen is an indication for diagnostic vitrectomy, Davis said, but when only fluid is needed, then a vitreous tap or an anterior chamber tap to be assayed with polymerase chain reaction methods is all that is needed.
For tissue biopsy, Davis said to select a newly involved spot and then do the vitrectomy with elevation of hyaloid.
“These things can be aspirated with a soft tip cannula. Draw up about 1 cc of fluid and send it for cytology,” she said, although the technique cannot be used when the lesion is flat. If the retina is involved, a piece of tissue must be obtained.
For the retinal biopsy, Davis selects a 3 mm by 5 mm site and uses laser demarcation and then diathermy of large vessels before aspirating the specimen.
Disclosure: Davis is a consultant to Xoma and does contracted research for Santen.