Laboratory workup in pars plana diagnostic vitrectomy: a case series of Brazilian patients
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Purpose
Diagnostic vitrectomy is helpful in elucidating the cause of uveitis, mainly when there is suspicion of intraocular malignancy. The aim of this study was to describe the performance of laboratory tests on vitreous specimens from individuals with uveitis at a Brazilian tertiary referral center.
Methods
Retrospective study of patients who underwent pars plana vitrectomy for diagnostic purposes between 2014 and 2023. Laboratory analysis could be microbiology analysis, PCR, cytopathology, flow cytometry and interleukin analysis. Not all tests were performed in all patients. Final diagnoses were determined for each case based on all available information, including the patient’s history, clinical course, response to treatment and intraocular fluid analysis.
Results
A total of 18 patients were included, 12 were women (66.7%), with mean age of 55.6±18.2 years old. The average time from symptoms to surgery was 7 months (range: 1-48). Diagnostic vitrectomy established the etiology in 7 of 11 patients that were suspected of malignancy. None of the cases of vitreoretinal lymphoma had positive cytological results. Of the 7 patients diagnosed as having intraocular hematologic malignancy, 3 were known to have hematologic malignancy before the surgery (1 had acute myeloid leukemia, 2 had lymphoma). Of 11 patients with uveitis, final diagnosis were CMV infection (1), toxoplasmosis (3), herpes infection (1), fungal endophthalmitis (3) and idiopathic (3).
Conclusion
Careful planning according to available laboratory tests of vitreous specimens is valuable to provide a definitive diagnosis in many cases, confirming the etiologic agent of infectious uveitis and more importantly pointing to a malignant masquerade syndrome.
Conflict of interest
No
1
Last name
KATO
Initials of first name(s)
JM
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
2
Last name
Ferracioli-Oda
Initials of first name(s)
E
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
3
Last name
Tanaka
Initials of first name(s)
T
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
4
Last name
Rodriguez
Initials of first name(s)
EEC
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
5
Last name
Soriano
Initials of first name(s)
DS
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
6
Last name
Preti
Initials of first name(s)
RC
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
7
Last name
Reis
Initials of first name(s)
R
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
8
Last name
Jorge
Initials of first name(s)
AT
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
9
Last name
Frazao
Initials of first name(s)
MAM
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
10
Last name
Lazari
Initials of first name(s)
CS
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
11
Last name
Araujo
Initials of first name(s)
EMPA
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
12
Last name
Antonangelo
Initials of first name(s)
L
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
13
Last name
Silva
Initials of first name(s)
MCA
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
14
Last name
Lima
Initials of first name(s)
PP
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
15
Last name
Hirata
Initials of first name(s)
CE
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
16
Last name
Yamamoto
Initials of first name(s)
JH
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
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