Chorioretinal biopsies are useful in providing a diagnosis for patients with cases of intraocular inflammation or chorioretinal lesions, according to research published in the Canadian Journal of Ophthalmology. Identifying these patients can help clinicians manage diseases appropriately, or refer them to a specialist who can. 

Researchers enrolled 7 participants (mean age 75.4±13.1 years, 4 men) in the 2-center study conducted between 2014-2020. The team reviewed electronic medical records and performed visual acuity (VA) assessments at baseline, and at 1-month and 1-year follow-up visits. Surgeons performed pars plana vitrectomy (PPV) on all participants to obtain chorioretinal biopsies. 

Overall, the procedure directly led to a diagnosis in 5 (71%) of the patients, with 1 participant receiving a diagnosis through vitreous samples. Diagnoses among the cohort included chorioretinal lymphoma (n=2), toxoplasmosis (n=1), benign choroidal mass (n=1), non-necrotizing granuloma (n=1), and peripheral exudative hemorrhagic chorioretinopathy (n=1). A single participant did not receive a definitive diagnosis. 


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Investigators acknowledge the invasive nature of chorioretinal biopsies, but stress the fact that no participants experienced any adverse effects following the procedure. They also highlight the fact that  it can identify potentially fatal diseases — a task that eye care clinicians are seldom faced with. 

“Chorioretinal biopsies helped to obtain a final diagnosis in 5 patients, with another patient being diagnosed from vitreous sampling during the concurrent PPV. This is a high rate of diagnosis that also represents clinically meaningful results that influence management and prognosis” according to the researchers. The team suggests that “future investigations could help identify in which patients the yield of chorioretinal biopsy would be best and in whom this could be an effective diagnostic tool after initial aqueous and/or vitreous taps had returned negative.”

Study limitations include a small sample size.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Hébert M, You E, Touma S, Bourgault S, Hammamji K, Dirani A. Indications and pathologic diagnoses of diagnostic chorioretinal biopsies in the province of Quebec, Canada. Can J Ophthalmol. Published online June 15, 2022. doi:10.1016/j.jcjo.2022.05.008