Diagnotic Teting of Vitrectomy pecimen

Purpoe To ae the uefulne of diagnotic tet that are performed on vitrectomy pecimen from patient with upected lymphoma or infection. Deign Noncomparative, retropective, interventional cae erie. Method eventy-eight conecutive patient (84 eye) underwent par plana vitrectomy for diagnotic purpoe. Vitrectomy with cytologic, cytofluorographic, or microbiologic analyi of vitreou ample wa performed. The main outcome meaure were the efficiency of diagnotic procedure and poitive and negative predictive value (PPV and NPV). Reult There were 28 patient (33 eye) with upected intraocular lymphoma and 50 patient (51 eye) with upected infection, which wa ubdivided into chronic endogenou endophthalmiti, atypical chorioretiniti, or chronic potoperative inflammation. Vitreou teting led to a diagnoi in 48 of 78 patient (61.5%); 14 patient with a final diagnoi of lymphoma/leukemia, and 34 patient with a final diagnoi of infection. When preoperative indication wa compared with final clinical diagnoi, the efficiency of the diagnotic procedure of cytologic evaluation, flow cytometry, and bacterial/fungal culture wa 67%, 79%, and 96%, repectively. For lymphoma, the PPV of cytologic evaluation wa 100% and the NPV 60.9%. For infection, the PPV of bacterial/fungal culture wa 100% and the NPV 94.9%. CD22+ B lymphocyte ≥20% of total cell on cytofluorographic analyi had a PPV of 88% for lymphoma. A cytofluorographic CD4:CD8 T-lymphocyte ratio ≥4 had a PPV of 70% for immunologically mediated uveiti. urgical complication were rare and manageable. Concluion Diagnotic vitrectomy in elected patient with carefully planned teting i an effective mean of upporting diagnoe in intraocular lymphoma, chronic intraocular infection, and atypical chorioretiniti. Flow cytometry quantitate the percentage and ratio of variou cell type and i helpful in contrating intraocular lymphoma with immunologically mediated uveiti