Transretinal uveal melanoma biopsy with 25‐gauge vitrectomy system

Abstract

ABSTRACT.Purpose: To evaluate the efficacy and the safety of uveal melanoma transretinal biopsy using 25-gauge vitrectomy system. Methods: At the patient's request of a tissue diagnosis, nine posterior uveal melanomas treated by proton-beam therapy were biopsied during the insertion of tantalium markers. Results: The diagnosis was uveal melanoma, confirmed in all cases using cytological (7 of 9) and histological analysis (2 of 9). Immunocytochemistry was performed on all samples (9 of 9). In eight of nine patients, minor postoperative vitreous haemorrhages were seen, which resolved in 1 day. No other ocular complications were noticed. Conclusion: Uveal melanoma biopsy using 25-gauge vitrectomy system is a valuable procedure to confirm the diagnosis, with adequate sample and low ocular morbidity.

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

“…Our finding is comparable to frequencies reported by other case series of vitreous cutter biopsies ranging from 72.2% to 88.9% (Abi‐Ayad et al. ; Grewal et al. ; Nagiel et al.…”

Safety of Pars Plana Vitrectomy in Eyes With Plaque-Irradiated Posterior Uveal Melanoma

“…Five studies with a total of 35 patients have reported safety outcomes after PPV with transretinal biopsy in eyes with untreated melanoma. [21][22][23][24][25] After histopathologic confirmation of melanoma, these eyes underwent treatment with plaque radiotherapy (13 eyes), enucleation (11 eyes), protonbeam irradiation (10 eyes), or transscleral resection (1 eye). No cases of intraocular melanoma dissemination, extrascleral extension of melanoma, or local melanoma recurrence were detected.…”

Outcomes of 27-Gauge Vitrectomy-Assisted Choroidal and Subretinal Biopsy

“…[3][4][5][6] Although performed under direct visualization, it is challenging to assess the vitreous cutter probe depth within the choroidal tumor and chorioretinal biopsy does confer a greater risk of iatrogenic morbidity including subretinal hemorrhage, vitreous hemorrhage, retinal detachment and the possibility of extrascleral extension. 4,[7][8][9][10][11][12][13][14] First described in 2010 by Oshima et al, and recently introduced commercially, the 27-gauge microincision vitrectomy system offers advantages compared to larger gauges in terms of smaller scleral wounds, decreased postoperative pain and inflammation, and faster visual recovery. 15 Although the efficacy of transvitreal retinochoroidal biopsy with a 25-gauge vitrector system has been demonstrated, no series regarding outcomes of 27-gauge vitrectomy assisted transvitreal choroidal or subretinal biopsy have been published since the commercial introduction of this technology by several different manufacturers.…”