Vitrectomy and Vitrector Port Needle Biopsy of Choroidal Melanoma for Gene Expression Profile Testing Immediately before Brachytherapy

Reddy, Deepthi M.; Mason, Lauren; Mason, John O.; Crosson, Jason N.; Yunker, Jacob J.

doi:10.1016/j.ophtha.2017.03.053

Cited by 16 publications

(13 citation statements)

References 27 publications

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“…It has been proposed that performing a full vitrectomy during biopsy can entail a faster resolution of vitreous haemorrhage (Reddy et al. ). In our series (study II), the vitreous haemorrhage cleared spontaneously in most cases and only 5.9% of patients underwent subsequent vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

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Intraocular biopsy of uveal melanoma Risk assessment and identification of genetic prognostic markers

Bagger

2018

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

“…The procedure can be combined with prior removal of the vitreous body (vitrectomy) to reduce the risk of persistent vitreous haemorrhage (Reddy et al. ).…”

Section: Introductionmentioning

confidence: 99%

Intraocular biopsy of uveal melanoma Risk assessment and identification of genetic prognostic markers

Bagger

2018

Acta Ophthalmologica

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“…However, the needle is usually inserted in the thickest part of the lesion, avoiding the retinal vessels. The procedure can be combined with the prior removal of the vitreous body (vitrectomy) to reduce the risk of persistent vitreous hemorrhage or vitreous traction on the iatrogenic retinal break at the tumor entry site, which usually self-seals [30]. The sclerotomies are sutured and cryotherapy may be performed [26].…”

Section: Resultsmentioning

confidence: 99%

“…In general, FNAB seems to be safer than transvitreal biopsy in terms of vitreous hemorrhages, probably because of a limited manipulation of the tumor tissue and vessels [6,26]. It has been proposed that performing a full vitrectomy during biopsy can entail a faster resolution of vitreous hemorrhage [30]. A rarer complication of ocular tumor biopsy is rhegmatogenous retinal detachment, with a slightly higher incidence following TVRC than after transvitreal FNAB [4,31,36,59].…”

Section: Resultsmentioning

confidence: 99%

Uveal Melanoma Biopsy: A Review

Frizziero

Midena

Trainiti

et al. 2019

Cancers

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Intraocular tumor diagnosis is based on clinical findings supported by additional imaging tools, such as ultrasound, optical coherence tomography and angiographic techniques, usually without the need for invasive procedures or tissue sampling. Despite improvements in the local treatment of uveal melanoma (UM), the prevention and treatment of the metastatic disease remain unsolved, and nearly 50% of patients develop liver metastasis. The current model suggests that tumor cells have already spread by the time of diagnosis, remaining dormant until there are favorable conditions. Tumor sampling procedures at the time of primary tumor diagnosis/treatment are therefore now commonly performed, usually not to confirm the diagnosis of UM, but to obtain a tissue sample for prognostication, to assess patient’s specific metastatic risk. Moreover, several studies are ongoing to identify genes specific to UM tumorigenesis, leading to several potential targeted therapeutic strategies. Genetic information can also influence the surveillance timing and metastatic screening type of patients affected by UM. In spite of the widespread use of biopsies in general surgical practice, in ophthalmic oncology the indications and contraindications for tumor biopsy continue to be under debate. The purpose of this review paper is to critically evaluate the role of uveal melanoma biopsy in ophthalmic oncology.

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“…As such, a 27-gauge pars plana vitrectomy was performed and a choroidal biopsy taken in the temporal part of the lesion with a 27-gauge cutter. Vitrectomy-assisted choroidal biopsy, including 27-gauge, had been well described for choroidal melanoma [5, 6, 7]. It had not to our knowledge, however, been described for choroidal lymphoma.…”

Section: Case Presentationmentioning

confidence: 99%

Primary Choroidal Lymphoma Diagnosed with 27-Gauge Pars Plana Vitrectomy Choroidal Biopsy

Kam

Galvin

Cherepanoff

et al. 2019

Case Rep Ophthalmol

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BackgroundCurrently, transvitreal fine-needle aspiration biopsy is the most widely used tissue biopsy technique in cases of suspected intraocular lymphoma due to its relative simplicity and low trauma. The small sample produced, however, may be inadequate for diagnostic and prognostic analyses due to mechanical artefacts, insufficient material, or sampling errors. Small case series have demonstrated choroidal biopsy via vitrectomy to be safe and effective. With smaller-gauge vitrectomy instruments, visual recovery is rapid, and post-operative inflammation and conjunctival scarring is minimised. Furthermore, smaller-gauge instrumentation does not appear to affect the diagnostic yield of biopsies for intraocular lymphoma in vitro. We report a case of primary choroidal lymphoma successfully diagnosed with 27-gauge pars plana vitrectomy choroidal biopsy.Case PresentationA 72-year-old female presented with a 6-month history of painless blurred vision in her right eye. Fundus examination revealed a large pale choroidal mass centred on the posterior pole with overlying exudative retinal detachment. Enhanced depth imaging optical coherence tomography revealed a markedly thickened choroid with an undulating appearance. B-scan ultrasonography demonstrated diffuse, smooth thickening of the choroid, and retrobulbar extrascleral hypoechoic nodules. A 27-gauge pars plana vitrectomy was performed and choroidal biopsy taken. Histopathologic, immunohistochemical, and flow cytometry studies confirmed a diagnosis of extranodal marginal zone B-cell lymphoma. Systemic workup found no evidence of systemic lymphoma. As such, the patient was diagnosed with primary choroidal lymphoma. She underwent intensity-modulated external beam radiotherapy with subsequent resolution of disease.ConclusionsPrimary choroidal lymphoma can be safely and effectively diagnosed via 27-gauge vitrectomy choroidal biopsy.

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Vitrectomy and Vitrector Port Needle Biopsy of Choroidal Melanoma for Gene Expression Profile Testing Immediately before Brachytherapy

Cited by 16 publications

References 27 publications

Intraocular biopsy of uveal melanoma Risk assessment and identification of genetic prognostic markers

Intraocular biopsy of uveal melanoma Risk assessment and identification of genetic prognostic markers

Uveal Melanoma Biopsy: A Review

Primary Choroidal Lymphoma Diagnosed with 27-Gauge Pars Plana Vitrectomy Choroidal Biopsy

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