Objective: To examine the pathologic findings of eyes treated with ganciclovir implants. Design: Retrospective consecutive case series. Participants: Thirty-three eyes from 19 AIDS patients with ganciclovir implants. ...Objective: To examine the pathologic findings of eyes treated with ganciclovir implants. Design: Retrospective consecutive case series. Participants: Thirty-three eyes from 19 AIDS patients with ganciclovir implants. Methods: Pathologic specimens collected from 1993 through 1999 at the National Eye Institute were reviewed. Thirty-three eyes from 19 patients were identified with ganciclovir implants. The submitted eyes then were sectioned through the implant site and stained with hematoxylin and eosin, periodic acid-Schiff, and other special stains when needed. Medical records, including operative and postoperative notes, were reviewed carefully. Main Outcome Measure: Light microscopic findings at and around the site of implantation. Results: Scars of surgical perforation were present in all eyes. Fibrous ingrowth developed from the implant site into the vitreous in 32 of the 33 eyes. Vitreous hemorrhage was present in 18 of the 33 eyes. Poor wound apposition was found in 2 of the 33 eyes, both of which had undergone multiple procedures. Foreign body giant cell reactions were observed in most of the eyes related to suture material. Thirty-two of the 37 implant sites were located within the pars plana, whereas the other 5 were either on the border of the pars plana and pars plicata (n=4) or within the pars plicata (n=1). Hyalinization, atrophic changes of the ciliary body in the area of implantation, or both were observed in 18 eyes. Conclusions: The ganciclovir implant is well tolerated within the eye. Fibrous ingrowth is present in most eyes and seems to be a benign occurrence because of its limited extension. Microscopic vitreous hemorrhage is present in many eyes, especially those that underwent multiple procedures. Poor wound apposition occurred rarely and was found only in eyes that had undergone multiple procedures.展开更多
Purpose To compare cytologic with flow cytom etric results of vitreous biopsy specimens obtained to rule out primary intraocu lar lymphoma (PIOL). Study design Prospective noncomparative case series. Partic ipants Pat...Purpose To compare cytologic with flow cytom etric results of vitreous biopsy specimens obtained to rule out primary intraocu lar lymphoma (PIOL). Study design Prospective noncomparative case series. Partic ipants Patients suspected of having PIOL who underwent vitreous biopsy were eval uated. Methods Patients underwent a standard 3-port vitrectomy and vitreous bio psy to rule out PIOL. Each undiluted specimen was split, and half was prepared f or cytologic evaluation with the collodion bag method; the other half was submit ted for flow cytometric immunophenotyping (FCI). The diluted specimen was proces sed as a cell block for cytology. Main outcome measures Final diagnosis based on cytology and FCI. Results Ten of 14 patients had sufficient specimens for both cytologic and FCI evaluation. Three patients had chronic inflammation confirmed by both methods. Six patients had large cell lymphoma identified by both cytolog y and FCI. Two of those 6 patients initially had insufficient specimen for FCI. One patient had large cell lymphoma diagnosed cytologically that was initially n egative for a clonal population by FCI. All lymphomas were B-cell type. Conclus ions Cytologic evaluation is an accurate diagnostic technique to evaluate for PI OL. FCI is useful for immunophenotyping PIOL. Multiple biopsies may be required to achieve a diagnosis.展开更多
文摘Objective: To examine the pathologic findings of eyes treated with ganciclovir implants. Design: Retrospective consecutive case series. Participants: Thirty-three eyes from 19 AIDS patients with ganciclovir implants. Methods: Pathologic specimens collected from 1993 through 1999 at the National Eye Institute were reviewed. Thirty-three eyes from 19 patients were identified with ganciclovir implants. The submitted eyes then were sectioned through the implant site and stained with hematoxylin and eosin, periodic acid-Schiff, and other special stains when needed. Medical records, including operative and postoperative notes, were reviewed carefully. Main Outcome Measure: Light microscopic findings at and around the site of implantation. Results: Scars of surgical perforation were present in all eyes. Fibrous ingrowth developed from the implant site into the vitreous in 32 of the 33 eyes. Vitreous hemorrhage was present in 18 of the 33 eyes. Poor wound apposition was found in 2 of the 33 eyes, both of which had undergone multiple procedures. Foreign body giant cell reactions were observed in most of the eyes related to suture material. Thirty-two of the 37 implant sites were located within the pars plana, whereas the other 5 were either on the border of the pars plana and pars plicata (n=4) or within the pars plicata (n=1). Hyalinization, atrophic changes of the ciliary body in the area of implantation, or both were observed in 18 eyes. Conclusions: The ganciclovir implant is well tolerated within the eye. Fibrous ingrowth is present in most eyes and seems to be a benign occurrence because of its limited extension. Microscopic vitreous hemorrhage is present in many eyes, especially those that underwent multiple procedures. Poor wound apposition occurred rarely and was found only in eyes that had undergone multiple procedures.
文摘Purpose To compare cytologic with flow cytom etric results of vitreous biopsy specimens obtained to rule out primary intraocu lar lymphoma (PIOL). Study design Prospective noncomparative case series. Partic ipants Patients suspected of having PIOL who underwent vitreous biopsy were eval uated. Methods Patients underwent a standard 3-port vitrectomy and vitreous bio psy to rule out PIOL. Each undiluted specimen was split, and half was prepared f or cytologic evaluation with the collodion bag method; the other half was submit ted for flow cytometric immunophenotyping (FCI). The diluted specimen was proces sed as a cell block for cytology. Main outcome measures Final diagnosis based on cytology and FCI. Results Ten of 14 patients had sufficient specimens for both cytologic and FCI evaluation. Three patients had chronic inflammation confirmed by both methods. Six patients had large cell lymphoma identified by both cytolog y and FCI. Two of those 6 patients initially had insufficient specimen for FCI. One patient had large cell lymphoma diagnosed cytologically that was initially n egative for a clonal population by FCI. All lymphomas were B-cell type. Conclus ions Cytologic evaluation is an accurate diagnostic technique to evaluate for PI OL. FCI is useful for immunophenotyping PIOL. Multiple biopsies may be required to achieve a diagnosis.
