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Diagnostic testing of vitrectomy specimens.

Janet L Davis¹, Daniel M Miller, Phillip Ruiz

¹Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA. jdavis@med.miami.edu

American Journal of Ophthalmology

|November 29, 2005

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Diagnostic vitrectomy effectively supports diagnoses for intraocular lymphoma and infections. Vitreous sample analysis, including flow cytometry, aids in identifying these conditions with high accuracy.

Area of Science:

Ophthalmology
Medical Diagnostics
Oncology

Background:

Intraocular lymphoma and chronic infections present diagnostic challenges.
Pars plana vitrectomy is a surgical procedure to access the vitreous cavity.

Purpose of the Study:

To evaluate the diagnostic utility of tests performed on vitrectomy specimens.
To assess the effectiveness of vitrectomy in diagnosing intraocular lymphoma and infections.

Main Methods:

Retrospective analysis of 78 patients undergoing diagnostic pars plana vitrectomy.
Analysis of vitreous samples using cytology, flow cytometry, and microbiologic cultures.
Evaluation of diagnostic procedure efficiency, positive predictive value (PPV), and negative predictive value (NPV).

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Main Results:

Vitrectomy led to a diagnosis in 61.5% of patients (lymphoma or infection).
Diagnostic test efficiencies: cytology (67%), flow cytometry (79%), microbiologic culture (96%).
High PPV for lymphoma (cytology 100%) and infection (culture 100%); high NPV for infection (culture 94.9%).

Conclusions:

Diagnostic vitrectomy with targeted testing is effective for intraocular lymphoma, infections, and atypical chorioretinitis.
Flow cytometry aids in differentiating intraocular lymphoma from immunologically mediated uveitis.