The diagnostic yield of vitrectomy specimen analysis in chronic idiopathic endogenous uveitis

Garweg, J G; Wanner, D; Sarra, G-M; Altwegg, M; Loosli, H; Kodjikian, L; Halberstadt, M (2006). The diagnostic yield of vitrectomy specimen analysis in chronic idiopathic endogenous uveitis. European journal of ophthalmology, 16(4), pp. 588-94. Milano: Wichtig Editore

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PURPOSE: The low diagnostic yield of vitrectomy specimen analysis in chronic idiopathic uveitis (CIU) has been related to the complex nature of the underlying disease and to methodologic and tissue immanent factors in older studies. In an attempt to evaluate the impact of recently acquired analytic methods, the authors assessed the current diagnostic yield in CIU. METHODS: Retrospective analysis of consecutive vitrectomy specimens from patients with chronic endogenous uveitis (n = 56) in whom extensive systemic workup had not revealed a specific diagnosis (idiopathic) and medical treatment had not resulted in a satisfying clinical situation. Patients with acute postoperative endophthalmitis served a basis for methodologic comparison (Group 2; n = 21). RESULTS: In CIU, a specific diagnosis provided in 17.9% and a specific diagnosis excluded in 21.4%. In 60.7% the laboratory investigations were inconclusive. In postoperative endophthalmitis, microbiological culture established the infectious agent in 47.6%. In six of eight randomly selected cases, eubacterial PCR identified bacterial DNA confirming the culture results in three, remaining negative in two with a positive culture and being positive in three no growth specimens. A double negative result never occurred, suggesting a very high detection rate, when both tests were applied. CONCLUSIONS: The diagnostic yield of vitrectomy specimen analysis has not been improved by currently routinely applied methods in recent years in contrast to the significantly improved sensitivity of combined standardized culture and PCR analysis in endophthalmitis. Consequently, the low diagnostic yield in CIU has to be attributed to insufficient understanding of the underlying pathophysiologic mechanisms.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology 04 Faculty of Medicine > Service Sector > Institute of Pathology
UniBE Contributor:	Garweg, Justus, Sarra, Gian-Marco, Loosli, Heinz, Halberstadt, Markus
ISSN:	1120-6721
ISBN:	16952099
Publisher:	Wichtig Editore
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:45
Last Modified:	05 Dec 2022 14:14
PubMed ID:	16952099
Web of Science ID:	000207170700014
URI:	https://boris.unibe.ch/id/eprint/18856 (FactScience: 1110)