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01.12.2014 | Original research | Ausgabe 1/2014 Open Access

Journal of Ophthalmic Inflammation and Infection 1/2014

Directed conjunctival biopsy and impact of histologic sectioning methodology on the diagnosis of ocular sarcoidosis

Zeitschrift:
Journal of Ophthalmic Inflammation and Infection > Ausgabe 1/2014
Autoren:
Kelly M Bui, Jose M Garcia-Gonzalez, Sarju S Patel, Amy Y Lin, Deepak P Edward, Debra A Goldstein
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1869-5760-4-8) contains supplementary material, which is available to authorized users.
Kelly M Bui, Jose M Garcia-Gonzalez contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KMB is a medical retina fellow at the USC-Doheny Eye Institute. JMG is a vitreoretinal fellow at the University of Chicago. They were involved in the acquisition and interpretation of data and drafted the manuscript. SSP is an assistant professor of ophthalmology and director of uveitis service at the Weill Cornell Medical College. He was involved in the data analysis and revision of the manuscript. AYL is an assistant professor of ophthalmology and pathology and the director of the ophthalmic pathology laboratory at the University of Illinois at Chicago. DPE is a professor of ophthalmology and pathology at Wilmer Eye Institute and the director of research at King Khaled Eye Specialist Hospital in Saudi Arabia. AYL and DPE were involved in the interpretation of data and revision of the manuscript. DAG is a professor of ophthalmology and director of the uveitis service at Northwestern University Feinberg School of Medicine. She was involved in the conception and design of the study and revision of the manuscript. All authors have read and given final approval of the version of manuscript to be published and agree to be accountable for all aspects of the work.

Abstract

Background

Sarcoidosis is an idiopathic, multi-system, granulomatous disease with well-described ocular manifestations. However, other uveitic etiologies can manifest in a similar fashion, and ocular disease may precede systemic manifestations. Definitive diagnosis requires histologic confirmation of non-caseating granulomatous inflammation. This study reports the diagnostic yield of directed biopsy of conjunctival follicles in patients with uveitis suspected to be secondary to sarcoidosis, and compares an institutional standard tissue sectioning method to a multi-plane technique.

Results

A retrospective analysis was performed of all patients who underwent directed conjunctival biopsy for suspected ocular sarcoidosis. A total of eight patients were identified; all were females. Directed conjunctival biopsy was positive in three of seven patients using standard histologic processing method, a yield of 43%. Using the multi-plane technique increased the cumulative yield to 63%.

Conclusions

Directed conjunctival biopsy is a minimally invasive, cost-effective, and moderately high yield method of diagnosing ocular sarcoidosis. Using a multi-plane sectioning method may increase biopsy yield when standard sectioning techniques are negative.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
12348_2014_77_MOESM2_ESM.tiff
Authors’ original file for figure 3
12348_2014_77_MOESM3_ESM.tif
Literatur
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