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Vitrectomy and Whipple's disease.

W J Durant, T Flood, M F Goldberg

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |June 1, 1984
    PubMed
    Summary
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    Diagnosing Whipple's disease is possible using vitreous aspirate from vitrectomies. Early diagnosis of Whipple's disease can be achieved with appropriate staining methods, potentially years sooner than traditional methods.

    Area of Science:

    • Ophthalmology
    • Infectious Diseases
    • Gastroenterology

    Background:

    • Whipple's disease is a rare bacterial infection that can affect multiple organ systems.
    • Diagnosis typically relies on small intestine biopsy, which can be invasive and delayed.
    • Ocular involvement is a known, though less common, manifestation.

    Observation:

    • Two patients with Whipple's disease were diagnosed via vitreous aspirate analysis following vitrectomy surgery.
    • In one patient, the diagnosis could have been made three years earlier if Periodic Acid-Schiff (PAS) staining had been utilized on the vitrectomy specimen.
    • In the second patient, PAS-positive macrophages, indicative of Whipple's disease, were identified during the surgical procedure.

    Findings:

    • Vitreous aspirate from vitrectomy is a viable diagnostic sample for Whipple's disease.

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  • The use of PAS staining on ocular specimens can significantly expedite the diagnosis of Whipple's disease.
  • Timely identification of PAS-positive macrophages in ocular samples aids in early diagnosis.

    • Implications:

    • This suggests a potential for earlier diagnosis of Whipple's disease through ophthalmological examination and vitreous analysis.
    • Ophthalmologists may play a crucial role in the early detection of systemic Whipple's disease.
    • Incorporating specific stains like PAS in ocular pathology could improve diagnostic timelines and patient outcomes for Whipple's disease.