Choroidal biopsies for intraocular tumors of indeterminate origin.
OBJECTIVE
To evaluate the role of pars plana vitrectomy-assisted incisional biopsies in the management of choroidal tumors of unclear origin.


METHODS
Retrospective, noncomparative, consecutive interventional case series.


METHODS
Ten consecutive patients with indeterminate choroidal tumors underwent a standardized three-port pars-plana vitrectomy-assisted subretinal biopsy using a bimanual approach with standard intraocular forceps and a diamond knife. Specimens were fixed in formaldehyde embedded in paraffin and further subjected to histopathological and immunohistochemical analyses.


RESULTS
A histologic diagnosis was obtained in all (10 of 10) cases including choroidal melanoma (five of 10), metastasis (two of 10), subretinal hemorrhage (two of 10), and nodular scleritis (one of 10). Five eyes were enucleated as a result of the histologic diagnosis. Three cases of postoperative complications were seen in three patients (newly formed rhegmatogenous retinal detachment, increased serous retinal detachment, and vitreous hemorrhage). No cases of intra- or extraocular tumor spread were detected through follow-up periods ranging from 3 to 29 months.


CONCLUSIONS
Pars plana vitrectomy-assisted incisional biopsy is a valuable diagnostic procedure for cases of choroidal tumors of unknown origin in selected patients. However, the relatively high frequency of postoperative complications noted in the present study and the potential risk of dissemination of tumor cells underscores the importance of rigorous case selection.
Kvanta
Anders
A
Department of Clinical Neuroscience, St Erik's Eye Hospital, Karolinska Institutet, Polhemsgatan 50, SE-112 82 Stockholm, Sweden. andres.kvanta@sankterik.se
Seregard
Stefan
S
Kopp
Eva Dafgard
ED
All-Ericsson
Charlotta
C
Landau
Irene
I
Berglin
Lennart
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D002830:Choroid Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D003937:Diagnosis, Differential; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D012166:Retinal Hemorrhage / Q000473:pathology; D012189:Retrospective Studies; D015423:Scleritis / Q000473:pathology; D014821:Vitrectomy / Q000379:methods