Advertisement

Indications and pathologic diagnoses of diagnostic chorioretinal biopsies in the province of Quebec, Canada

      Abstract

      Objective

      To review the clinical usefulness of chorioretinal biopsies in diagnostically undefined cases of intraocular inflammation or chorioretinal lesions.

      Design

      Retrospective case series.

      Participants

      Seven patients who underwent chorioretinal biopsies.

      Methods

      This case series included all consecutive patients who underwent chorioretinal biopsies in 2 academic tertiary care centres in the province of Quebec between 2014 and 2020.

      Results

      A total of 7 patients were included in the study. Five patients with intraocular inflammation underwent chorioretinal biopsies to rule out an infectious or neoplastic etiology, whereas 2 patients underwent biopsies for suspicion of neoplastic chorioretinal masses. Final diagnoses included primary chorioretinal lymphoma (n = 2), toxoplasmosis (n = 1), benign choroidal mass (n = 1), nonnecrotizing granuloma (n = 1), and peripheral exudative hemorrhagic chorioretinopathy (n = 1). No specific diagnosis was defined in 1 case of panuveitis with scleritis. No postoperative complications were reported.

      Conclusions

      Chorioretinal biopsies clarified the diagnosis in 6 of 7 patients, including a definitive diagnosis of lymphoma in 2 patients. This is a high rate of diagnosis that also represents clinically meaningful results that influence management. Future directions include identifying patients in whom adjuvant chorioretinal biopsy would yield a high rate of diagnosis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Grimm SA
        • Pulido JS
        • Jahnke K
        • et al.
        Primary intraocular lymphoma: an International Primary Central Nervous System Lymphoma Collaborative Group Report.
        Ann Oncol. 2007; 18: 1851-1855
        • Grange LK
        • Kouchouk A
        • Dalal MD
        • et al.
        Neoplastic masquerade syndromes among uveitis patients.
        Am J Ophthalmol. 2014; 157: 526-531
        • Chatzistefanou K
        • Markomichelakis NN
        • Christen W
        • Soheilian M
        • Foster CS.
        Characteristics of uveitis presenting for the first time in the elderly.
        Ophthalmology. 1998; 105: 347-352
        • Grégoire MA
        • Kodjikian L
        • Varron L
        • Grange JD
        • Broussolle C
        • Seve P.
        Characteristics of uveitis presenting for the first time in the elderly: analysis of 91 patients in a tertiary center.
        Ocul Immunol Inflamm. 2011; 19: 219-226
        • Rothova A
        • de Boer JH
        • ten Dam-van Loon NH
        • et al.
        Usefulness of aqueous humor analysis for the diagnosis of posterior uveitis.
        Ophthalmology. 2008; 115: 306-311
        • Harper TW
        • Miller D
        • Schiffman JC
        • Davis JL.
        Polymerase chain reaction analysis of aqueous and vitreous specimens in the diagnosis of posterior segment infectious uveitis.
        Am J Ophthalmol. 2009; 147 (.e2): 140-147
        • Soussain C
        • Malaise D
        • Cassoux N.
        Primary vitreoretinal lymphoma: a diagnostic and management challenge.
        Blood. 2021; 138: 1519-1534
        • Pichi F
        • Sarraf D
        • Arepalli S
        • et al.
        The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases.
        Prog Retin Eye Res. 2017; 59: 178-201
        • Asencio-Duran M
        • Vallejo-Garcia JL
        • Pastora-Salvador N
        • Fonseca-Sandomingo A
        • Romano MR.
        Vitreous diagnosis in neoplastic diseases.
        Mediators Inflamm. 2012; 2012e930704
        • Davis JL
        • Miller DM
        • Ruiz P.
        Diagnostic testing of vitrectomy specimens.
        Am J Ophthalmol. 2005; 140 (.e2): 822-829
        • Mastropasqua R
        • Di Carlo E
        • Sorrentino C
        • Mariotti C
        • da Cruz L.
        Intraocular biopsy and immunomolecular pathology for “unmasking” intraocular inflammatory diseases.
        J Clin Med. 2019; 8: 1733
        • Vann VR
        • Giuliari GP
        • Banda RM
        • Chévez-Barrios P
        • Fuller GN
        • Gombos DS.
        Choroidal melanoma masquerading as panuveitis in a patient with multiple myeloma.
        Retin Cases Brief Rep. 2009; 3: 152-155
        • Butler NJ
        • Furtado JM
        • Winthrop KL
        • Smith JR.
        Ocular toxoplasmosis II: clinical features, pathology and management.
        Clin Exp Ophthalmol. 2013; 41: 95-108
        • Birnbaum AD
        • Huang W
        • Sahin O
        • Tessler HH
        • Goldstein DA.
        Ocular sarcoidosis misdiagnosed as primary intraocular lymphoma.
        Retina. 2010; 30: 310-316
        • Biswas J
        • Madhavan HN
        • Gopal L
        • Badrinath SS.
        Intraocular tuberculosis: clinicopathologic study of five cases.
        Retina. 1995; 15: 461-468
        • Huggins A
        • Adam M
        • Ehmann D
        • Eagle RC
        • Malloy B
        • Garg SJ.
        A case of intravesical bacillus Calmette-Guerin–related endophthalmitis and retinitis confirmed with retinal biopsy.
        Retin Cases Brief Rep. 2019; 13: 333-336
        • Shen DF
        • Zhuang Z
        • LeHoang P
        • et al.
        Utility of microdissection and polymerase chain reaction for the detection of immunoglobulin gene rearrangement and translocation in primary intraocular lymphoma.
        Ophthalmology. 1998; 105: 1664-1669
        • Rutzen AR
        • Ortega-Larrocea G
        • Dugel PU
        • Chong LP
        • Lopez PF
        • Rao NA.
        Retinal and choroidal biopsy in intraocular inflammation: a clinicopathologi study.
        Trans Am Ophthalmol Soc. 1994; 92: 431-458
        • Martin DF
        • Chan CC
        • de Smet MD
        • et al.
        The role of chonoretinal biopsy in the management of posterior uveitis.
        Ophthalmology. 1993; 100: 705-714