Vitreous aspiration needle tap in the diagnosis of intraocular inflammation

To determine the safety of vitreous aspiration needle tap as a clinical procedure and its usefulness in helping to distinguish between infective, inflammatory, and malignant causes of uveitis.

Retrospective, noncomparative case series.

Data were collected for 53 patients who had undergone vitreous aspiration needle tap as an outpatient in the clinic.

These patients underwent vitreous aspiration needle tap using a needle and syringe for the following indications: (1) when masquerade syndrome or infective retinitis was the primary diagnosis; and (2) to diagnose or exclude infective or malignant entities in patients not responding to treatment. The result of the analysis of the biopsy specimen and any complications that arose from the procedure were determined.

In this series, vitreous aspiration needle tap generated an adequate sample for the relevant investigations in 92% of cases. The initial diagnosis of intraocular malignancy or infection was confirmed in 40% of patients. The remaining patients were treated with immunosuppressives for the ocular inflammation and showed clinical improvement over the follow-up period. Multiple procedures were required in two patients to make the diagnosis of B-cell intraocular lymphoma and in two patients with acute retinal necrosis who were treated for the presenting clinical features.

Vitreous aspiration needle tap would seem to be a safe clinical procedure, which has a high success rate in differentiating between infectious, inflammatory, and malignant causes of uveitis. It is a quick procedure that can be carried out at the first outpatient visit.