Research Article
Usefulness of Discarded Vitreous Samples from
Routine Vitrectomy
Natàlia Vilà,
1,2
Pablo Zoroquiain,
1
Vasco Bravo-Filho,
1
Emilia Antecka,
1
Helena Dietrich,
1
John C. Chen,
2
I. John Galic,
2
Michael A. Kapusta,
2
and Miguel N. Burnier Jr.
1,2
1
RI-MUHC, Henry C. Witelson Ocular Pathology Laboratory, 1001 Boulevard Decarie, Block E, Lab No. E02.2389, Montreal,
QC, Canada H4A 3J1
2
Department of Ophthalmology, McGill University, Montreal, QC, Canada
Correspondence should be addressed to Nat` alia Vil` a; natalia.vila@mail.mcgill.ca
Received 25 January 2016; Accepted 17 March 2016
Academic Editor: Van C. Lansingh
Copyright © 2016 Nat` alia Vil` a et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose. To describe the histopathological features of vitreous samples obtained afer vitrectomy surgery from diabetic and
nondiabetic patients. Methods. Vitreous specimens from 137 patients who underwent vitrectomy for diferent clinical conditions
were analysed. All samples were centrifuged and each resulting pellet was fxed and processed as part of routine parafn section
histopathology. Te histopathological features were categorized in a semiquantitative fashion. Te samples from diabetic and
nondiabetic patients were compared. Results. Te 125 included patients (58 diabetic, 60% males) were aged 64.2 ± 13.9 years. Te
presence of hemorrhage, infammatory cells, and histiocytes was signifcantly higher in the diabetic group ( < 0.001, = 0.028,
and = 0.016, resp.), showing more vessels ( < 0.001) and ghost vessels ( = 0.049). Te presence of infammatory cells was the
feature with the highest sensitivity for detecting diabetes mellitus (98%) and also the highest negative predictive value (89%). In the
multivariate analysis, three variables emerged as independent signifcant predictors of diabetes in vitrectomy samples: hemorrhage,
endothelial-lined vessels, and age ( < 0.001, < 0.001, and = 0.019, resp.). Conclusions. Diferent histopathological features can
be found in vitreous samples from diabetic patients. Analysis of vitrectomy samples may serve as a tool for diabetes management.
1. Introduction
Afer more than four decades, pars plana vitrectomy has
become routine for vitreoretinal surgeons. Vitrectomy can
beneft patients with many ocular disorders such as retinal
detachment, macular pathology, among other conditions. In
addition, vitrectomy can be performed to assess vitreous
cytology in order to rule out neoplastic processes in the
clinical context of chronic nonspecifc infammation or mas-
querade syndrome [1]. When this diferential diagnosis is
not required, the material collected from vitrectomy surgery
is frequently discarded because, to date, no importance has
been attributed to these specimens.
Te aim of the present study was to evaluate the
histopathological features of vitreous samples in diabetic and
nondiabetic patients. Diabetes mellitus (DM) is a metabolic
disorder that afects vascular regulation and causes microvas-
cular damage. Diabetic retinopathy (DR) is a common
complication of diabetic microangiopathy, afecting about
one-third of the patients with DM [2]. Moreover, prevalence
increases with increased duration of DM [3]. Screening for
DR is crucial for the early diagnosis of the asymptomatic
clinical fndings. At least, annual examinations of the ocular
fundus are recommended for DR screening in diabetic
patients [4].
Early stage of nonproliferative DR is manifested by
excessive capillary permeability leading to inner blood retinal
barrier dysfunction, capillary basement membrane thicken-
ing, pericyte and smooth muscle depletion, microaneurysm
formation, capillary closure, and nonperfusion [5, 6]. Early
signs of DR can only be detected by clinical observation when
this whole process has already started. Despite new technolo-
gies to detect retinal changes [7], a methodology for early
DR diagnosis before clinical and irreversible manifestations
appear is not available.
Hindawi Publishing Corporation
Journal of Ophthalmology
Volume 2016, Article ID 2380764, 6 pages
http://dx.doi.org/10.1155/2016/2380764