Diagnostic vitrectomy for the diagnosis and management of posterior uveitis of unknown etiology.
OBJECTIVE
Diagnostic vitrectomy is performed in cases of posterior segment inflammation that are suspicious for malignancy or infection and require tissue confirmation. Advances in vitrectomy technique and laboratory tests have improved the diagnostic yield in these challenging cases. The methods for obtaining vitreous specimens and the diagnostic tests used to analyze them are discussed.


RESULTS
Ancillary tests have been invaluable in addressing the diagnostic limitations of traditional histopathologic and microbiologic analyses. Flow cytometry, gene rearrangement studies, and cytokine measurements are useful adjuncts to cytology for the diagnosis of malignancy, in particular primary intraocular lymphoma. Microbial DNA amplification by polymerase chain reaction and intraocular antibody measurement has been shown to detect the presence of infection by organisms that are difficult to culture.


CONCLUSIONS
When performed appropriately, diagnostic vitrectomy with carefully selected ancillary testing can lead to a definitive diagnosis in a large proportion of cases.
Margolis
Ron
R
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. margolr2@ccf.org
D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D015203:Reproducibility of Results; D015866:Uveitis, Posterior / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology* / Q000601:surgery