First Author: N.Vilà CANADA
Co Author(s): V. Bravo-Filho P. Zoroquiain J. Chen J. Galic J. Deschênes M.N. Burnier 0 0 0 0 0 0 0 0 0
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The purpose of this study is to describe the histopathological features in vitreous samples from diabetic patients. To the best of our knowledge, there have been no published reports describing morphological features of diabetic vitreous cytology.
Henry C. Witelson Ocular Pathology Laboratory – Royal Victoria Hospital (McGill University)
Vitrectomy specimens from 124 patients (57 diabetic and 67 non-diabetic) who underwent pars plana vitrectomy for different clinical conditions (macular hole, epiretinal membrane, retinal detachment or diabetic retinopathy [DR]) were analyzed). The diabetic group included patients with and without DR. All samples were centrifuged at 2500 rpm for 15 minutes. The resulting pellet from each sample was fixed in a 1:1 alcohol and formalin solution. The supernatant was poured off and the sediment was processed as part of routine paraffin section histopathology (cell block). The slides were stained with H&E and scanned with a digital slide scanner (Aperio ScanScopeAT Turbo). Amount and type of vitreous matrix, presence of hemorrhage, number of vessels (epithelium-lined and ghost vessels) and aneurismatic dilatation were evaluated. Inflammatory cells as well as number of histiocytes, spindle and retinal pigment epithelium cells (RPE) were analyzed. Each sample was further classified using a scale (0=negative; 1=low; 2=high) and a comparison between diabetic and non-diabetic patients were established.
Of the 124 patients, 77 were male and 47 were female. The mean age was 60+/-14 years. The presence of hemorrhage was significantly higher in the diabetic group than the non-diabetic group (p=0.00; Positive predictive value [PPV]=66.7%; Negative predictive value [NPV]=65,8%). Moreover, the diabetic group had significantly more vessels (p=0.00; PPV=78.9%; NPV=63.1%) and ghost vessels (p=0.045; PPV=62.9%; PNV=58.8%). No significant difference was observed between the two groups with respect to the amount of vitreous matrix, presence of spindle cells, RPE and inflammatory cells.
Diabetic and non-diabetic patients display different histopathological features in vitreous samples. The presence of hemorrhage, vessels and ghost vessels were associated with the diagnosis of diabetes. The analysis of vitreous cytology is important to further understand the Diabetic Retinopathy mechanism and to diagnose clinically undetectable Diabetic Retinopathy. In addition, this technique may be used to evaluate Diabetic Retinopathy-like damage in glucose intolerant patients.