Ocular fluid analysis to pin down the cause of inflammation

Abstract

SummaryThe accuracy for the diagnosis of inflammatory eye diseases is a crucial step for an appropriate treatment strategy and their management in general. In most of the cases, non‐invasive techniques, such as fluorescein angiography, indocyanine green angiography and optical coherence tomography, can lead to a correct diagnosis. In addition, blood tests and neuro‐imaging can be strongly contributory. However, it has been estimated that in 8% of cases with uveitis, approximately, the clinical presentation can be atypical and, moreover, systemic medical evaluation might be non‐conclusive. In order to minimize such ambiguities, diagnostic sampling of ocular fluids can help in determining the etiology of the disease, and can provide sufficient evidences for the treatment management. The diagnostic tests for atypical or uncertain uveitis subsets include: anterior chamber tap, vitreous biopsy and chorioretinal biopsy. This lecture will focus on the indications, techniques, reliability and limitations of vitreous biopsy for ocular inflammatory or pseudo‐inflammatory diseases.