Diagnosis of intraocular lesions using vitreous humor and intraocular perfusion fluid cytology: Experience with 83 Cases.

Objective: The objective of the study was to evaluate the use of vitreous humor and/or intraocular perfusion fluid (IPF) from pars plana vitrectomy as a diagnostic and therapeutic procedure for intraocular diseases.

Methods: The cytologic findings with respect to the clinical data, the anatomical findings, and the final diagnosis in 83 cases that underwent intraocular cytologic examinations at the Kansai Medical University Takii Hospital were evaluated. For cytologic examination, the Papanicolaou stain, Giemsa stain, and in some cases, molecular biology and immunocytochemical techniques were used.

Results: Most of the clinical diagnoses were uveitis or endophthalmitis. Sixty-eight cases (81.9%) were negative on cytodiagnosis, while 15 cases (18.9%) were positive or suspicious for malignancy. Negative cases included infections and intraocular sarcoidosis (IOS), and all of the positive or suspicious cases were intraocular lymphomas. Some of these latter cases were also diagnosed using immunocytochemical staining or molecular biological procedures as ancillary techniques, performed using vitreous body cytology from IPF.

Conclusions: An early diagnosis and treatment of intraocular diseases is necessary to maintain an acceptable degree of quality of life. For an accurate diagnosis, it is necessary to understand the anatomy of the eye. Giemsa staining is recommended in addition to Papanicolaou staining for cytologic diagnostic evaluation of intraocular diseases. Furthermore, for the diagnosis of clonality in intraocular lymphomas, it is often necessary to use ancillary molecular biological procedures, using vitreous fluid.