Abstract
Vitreous biopsy is a valuable tool for the diagnosis and treatment of endophthalmitis, uveitis, and other undiagnosed intraocular inflammation. The role of vitreous biopsy as a requisite diagnostic tool was established with the publication of the Endophthalmitis Vitrectomy Study (EVS) in 1995. Since then, we have seen an evolution in diagnostic capacity and a rapidly expanding pharmacologic armamentarium. These changes have only reinforced the usefulness of the vitreous biopsy for accurate diagnosis and targeting of treatment. Indications for biopsy fall into several categories including endophthalmitis, failure of initial therapy, and decisional management of intraocular inflammation after negative systemic workup. The three common methods of obtaining vitreous culture are through the traditional three-port pars plana vitrectomy, mechanical, handheld vitrectomy system, or via needle aspiration. These biopsies may be done in the office, operating room, or at the bedside depending on the situation. This comprehensive review focuses on the diagnostic and therapeutic benefit of intravitreal biopsy, and surgical tools and techniques for performing the procedure.
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