Reliability of vitreous histological detection of pathogenic fungi in the diagnosis of fungal endophthalmitis.
OBJECTIVE
To assess the value of histopathologic investigations of vitreous biopsy specimens in the diagnosis of fungal endophthalmitis compared with that of conventional smear and fungal culture.


METHODS
In this prospective study, 10 patients with clinically suspected fungal endophthalmitis of any etiology underwent intravitreal sampling and vitrectomy for diagnostic and therapeutic purposes. Infused vitreous biopsy samples were centrifuged and mixed with blood serum for hematoxylin and eosin and periodic-acid Schiff staining, whereas the remaining samples were submitted for smear and fungal culture. All slides were reviewed by an attending pathologist.


RESULTS
Vitreous specimens were obtained from 10 eyes of 10 patients. Positive histological diagnoses of fungal endophthalmitis from vitreous biopsies were made in seven cases (70%). The sensitivity of histological detection of fungi was higher than conventional smear (50%) or culture (40%); all these techniques are complementary.


CONCLUSIONS
Specific histopathological detection of pathogenic fungi in clinical vitreous specimens could be helpful for the diagnosis of suspected fungal endophthalmitis. Positive histopathology results were seen in the majority of samples; however, difficulties in determining related fungal etiology limit its application.
Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
K
K
Liu
Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
F
F
Fang
Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
H
H
Li
D000328:Adult; D001706:Biopsy; D009877:Endophthalmitis / Q000175:diagnosis* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology*; D055815:Young Adult