In the following article, you can read a brief examination of the role of vitrectomy in the diagnosis and treatment of uveitis.<\/p>\n
In 1970 Robert Machemer, MD developed the technique of vitrectomy - vitrectomy (PPV) in terms of its use in the diagnosis and treatment of both infectious and neoplastic conditions.<\/p>\n
In 1975, Michels first reported the diagnosis of sarcoma (i.e. intraocular lymphoma) using the technique of vitrectomy - vitrectomy. Within six years the first paper on the use of vitrectomy in the control and treatment of uveitis was published.<\/p>\n
As vitrectomy - vitrectomy became more effective and safer, mainly due to advances in technology, with the use of smaller instruments and wide viewing methods, it was successfully used in the diagnosis of posterior pole uveitis and conditions with similar symptoms to uveitis.<\/p>\n
DIAGNOSIS BY VITRECTOMY - VITRECTOMY<\/strong><\/p>\n Lymphoma or uveitis?;<\/strong><\/p>\n Most patients with intraocular lymphoma will present with posterior or total uveitis. Therefore, it is important to know the features of the disease and to be suspicious of similar cases. The key area for the diagnosis of lymphoma remains cytology. A first sample is taken immediately at the start of vitrectomy - vitrectomy using small diameter instruments, with the injection closed or turned to air, to achieve the largest collection of cells.<\/p>\n Imaging with different machines, detailed clinical examination, imaging of the brain and careful handling of the specimens by the ophthalmologist or pathologist are of paramount importance. Recent evidence has shown that the use of low cutting rates (500 to 1,000 cpm) help to optimize cellular integrity. Cell sensitivity remains low despite improvements in techniques and ancillary assays, which help in the proper management of the patient even if there is no definitive cytological diagnosis.<\/p>\n Brain MRI every 6 to 12 months can help in the early diagnosis of central nervous system lymphoma. In many cases, vitreoretinal testing may not help in making a definitive diagnosis, but infiltration biopsy can help, with proper diagnostic testing. This is often achieved by creating a small retinotomy adjacent to the infiltrate using intraocular diathermy and then using a soft cannula to move the retinotomy over the infiltrate to aspirate the infiltrate into a syringe. In rare cases, a chorioretinal biopsy may be necessary for a final diagnosis.<\/p>\n Is it infectious?;<\/strong><\/p>\n Diagnostic testing for infectious uveitis is essential. Vitrectomy-vitrectomy is often used to collect specimens for culture in patients with postoperative endophthalmitis who have vision, motor hand perception or worse, in patients with chronic postoperative endophthalmitis or suspected endogenous endophthalmitis. In these cases, careful management of specimens for culture in the microbiology laboratory is important.<\/p>\n The polymerase reaction can be useful for the rapid identification of bacterial, fungal and mycobacterial pathogens. The polymerase reaction is also necessary for the identification of viruses, toxoplasmosis and tuberculosis. If the presence of pathogenic micro-organisms is suspected, intra-operative antibiotics may be administered. If retinal detachment is present, silicone oil may be used to maintain postoperative fundus visibility and this may provide some antimicrobial properties.<\/p>\n Surgeons can safely use 27G instruments in many of these cases as it does not appear that cutting rates or dilution of the specimen by fluid injection have any impact on the diagnosis.<\/p>\n TREATMENT WITH VITRECTOMY - VITRECTOMY<\/strong><\/p>\n Vitrectomy has been used to treat many complications of uveitis, such as retinal detachment, retinal detachment, retinal membrane, macular hole, cystic macular edema and vitreous opacity. In all these cases, intraoperative control of inflammation is necessary. However, no comparative data are available to help guide intraoperative control options.<\/p>\n Antibiotics are safe for most patients with uveitis from infectious causes, such as toxoplasmosis or acute retinal necrosis. Steroids during surgery can be administered orally, injected into the sub-tenonal space or administered topically, and the choice of agent and dose can be adjusted in the face of the risk of recurrent uveitis. For example, for an otherwise healthy patient with difficult-to-control intermediate uveitis who has been treated for 2 years with methotrexate and epiretinal membrane ablation, we would suggest adding 30 mg prednisone daily to methotrexate starting 1 week before surgery and continuing 2 weeks after surgery with rapid tapering, in addition to the use of a topical steroid. On the other hand, for a diabetic patient with anterior uveitis who had been asymptomatic for 3 years without the use of drugs, we would recommend the use of Durezol (Novartis) topically, four times daily for a few weeks after surgery followed by gradual tapering.<\/p>\n Continuous re-examinations for any cystic macular edema, retinal vasculitis, presence of cells in the anterior chamber or vitreous and\/or new chorioretinal lesions in selected patients are necessary in the postoperative period. The results of studies on the visual benefit of using vitrectomy-vitrectomy for the treatment of uveitis complications are largely lagging. However, modern vitrectomy-vitrectomy techniques combined with appropriate inflammation control and careful monitoring can lead to good surgical outcomes in patients treated for uveitis complications with standard surgical techniques.<\/p>\n Because we remove immune cells and cytokines from the vitreous cavity, vitrectomy - vitrectomy has long been considered to play an important role in the treatment of ocular inflammation. Although some evidence supports this therapeutic role, its efficacy is unclear. Therefore, due to the lack of proven benefit, the use of vitrectomy - vitrectomy as a means of controlling intraocular inflammation should remain as a last resort.<\/p>\n WITH A QUICK GLANCE<\/strong><\/p>\n USEFUL INFORMATION<\/strong><\/p>\n \u03a3\u03c4\u03bf \u03ac\u03c1\u03b8\u03c1\u03bf \u03c0\u03bf\u03c5 \u03b1\u03ba\u03bf\u03bb\u03bf\u03c5\u03b8\u03b5\u03af, \u03bc\u03c0\u03bf\u03c1\u03b5\u03af\u03c4\u03b5 \u03bd\u03b1 \u03b4\u03b9\u03b1\u03b2\u03ac\u03c3\u03b5\u03c4\u03b5 \u03bc\u03b9\u03b1 \u03c3\u03cd\u03bd\u03c4\u03bf\u03bc\u03b7 \u03b5\u03be\u03ad\u03c4\u03b1\u03c3\u03b7 \u03c4\u03bf\u03c5 \u03c1\u03cc\u03bb\u03bf\u03c5 \u03c4\u03b7\u03c2 \u03c5\u03b1\u03bb\u03bf\u03b5\u03b9\u03b4\u03b5\u03ba\u03c4\u03bf\u03bc\u03ae\u03c2 \u03c3\u03c4\u03b7 \u03b4\u03b9\u03ac\u03b3\u03bd\u03c9\u03c3\u03b7 \u03ba\u03b1\u03b9 \u03c4\u03b7 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1 \u03c4\u03b7\u03c2 \u03c1\u03b1\u03b3\u03bf\u03b5\u03b9\u03b4\u03af\u03c4\u03b9\u03b4\u03b1\u03c2. \u03a4\u03bf 1970 \u03c0\u03c1\u03b1\u03b3\u03bc\u03b1\u03c4\u03bf\u03c0\u03bf\u03b9\u03ae\u03b8\u03b7\u03ba\u03b5 \u03b1\u03c0\u03cc \u03c4\u03bf\u03bd Robert Machemer, MD \u03b7 \u03b5\u03be\u03ad\u03bb\u03b9\u03be\u03b7 \u03c4\u03b7\u03c2 \u03c4\u03b5\u03c7\u03bd\u03b9\u03ba\u03ae\u03c2 \u03c4\u03b7\u03c2 \u03c5\u03b1\u03bb\u03bf\u03b5\u03b9\u03b4\u03b5\u03ba\u03c4\u03bf\u03bc\u03ae\u03c2 – \u03b2\u03b9\u03c4\u03c1\u03b5\u03ba\u03c4\u03bf\u03bc\u03ae\u03c2 (PPV) \u03cc\u03c3\u03bf \u03b1\u03c6\u03bf\u03c1\u03ac \u03c4\u03b7 \u03c7\u03c1\u03ae\u03c3\u03b7 \u03c4\u03b7\u03c2 \u03c3\u03c4\u03b7 \u03b4\u03b9\u03ac\u03b3\u03bd\u03c9\u03c3\u03b7 \u03ba\u03b1\u03b9 \u03c4\u03b7 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1 \u03b1\u03bc\u03c6\u03cc\u03c4\u03b5\u03c1\u03c9\u03bd \u03bc\u03bf\u03bb\u03c5\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03ce\u03bd \u03ba\u03b1\u03b9 \u03bd\u03b5\u03bf\u03c0\u03bb\u03b1\u03c3\u03c4\u03b9\u03ba\u03ce\u03bd \u03ba\u03b1\u03c4\u03b1\u03c3\u03c4\u03ac\u03c3\u03b5\u03b9\u03c9\u03bd. \u03a4\u03bf 1975, […]<\/p>\n","protected":false},"author":1,"featured_media":216,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-1634","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-5"],"yoast_head":"\n
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