CLINICOPATHOLOGICAL STUDY OF RETINAL AND CHOROIDAL BIOPSIES IN INTRAOCULAR INFLAMMATION

PURPOSE: We reviewed the clinical and histopathologic features of 33 i ntraocular tissue biopsy specimens from 32 patients and assessed the v alue of retinal and chorioretinal biopsies performed in patients with intraocular inflammation. METHODS: Twenty four endoretinal biopsies an d nine chorioretinal or choroidal biopsies were performed, On the basi s of clinical indications, the specimens were processed for light micr oscopy, electron microscopy, immunohistochemical staining, in situ DNA hybridization, and polymerase chain reaction. RESULTS: Of the 24 endo retinal biopsy specimens, 19 were from patients with clinical signs su ggestive of viral retinitis, Overall, the diagnosis of viral retinitis was suggested by electron micros copy, immunohistochemical staining, in situ DNA hybridization, or polymerase chain reaction in 53% (ten of 19) biopsies, The preoperative diagnosis was confirmed in seven of te n biopsies in cases of suspected cytomegalovirus retinitis, in one of seven biopsies in cases of suspected acute retinal necrosis, and in tw o of two biopsies in cases of progressive outer retinal necrosis. The remaining five endoretinal biopsies disclosed Candida in one specimen, subretinal fibrosis in one, and chronic inflammation in three, Histol ogic examination of the nine chorioretinal or choroidal biopsies discl osed lymphoma in two specimens, a subretinal neovascular membrane in o ne, uveal melanocytic proliferation in one, toxoplasmic retinochoroidi tis in one, viral retinitis in one, and long-standing inflammation in three. CONCLUSION: In select cases of intraocular inflammation, intrao cular tissue biopsies may provide clinically useful information.