Michael I Seider1,2,3, Duncan E Berry3,4, Amy C Schefler5, Miguel Materin3, Sandra Stinnett3, Prithvi Mruthyunjaya6,7,8. 1. The Permanente Medical Group, San Francisco, CA, USA. 2. Department of Ophthalmology, University of California-San Francisco, San Francisco, CA, USA. 3. Department of Ophthalmology, Duke University, Durham, NC, USA. 4. Department of Ophthalmology, Emory University, Atlanta, GA, USA. 5. Retina Consultants of Houston/Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA. 6. Department of Ophthalmology, Duke University, Durham, NC, USA. Prithvi9@stanford.edu. 7. Byers Eye Institute, Stanford University, 2452 Watson Court, Palo Alto, CA, 94303, USA. Prithvi9@stanford.edu. 8. Stanford Cancer Institute, Stanford University, Palo Alto, CA, USA. Prithvi9@stanford.edu.
Abstract
PURPOSE: To investigate the relationship between surgical approach for intraocular tumor biopsy of uveal melanoma and tumor morphologic features such as size and intraocular location and the effect of these variables on diagnostic yield and biopsy outcome. METHODS: Consecutive patients from nine Ocular Oncology centers with uveal melanoma (UM) undergoing tumor biopsy immediately preceding I125 plaque brachytherapy with tissue sent for gene expression profiling (GEP) testing were reviewed retrospectively. RESULTS: Three hundred sixty patients were included (50% men, mean age 60.2 years). Overall biopsy yield was 99% and 83% for GEP and cytopathology, respectively. Surgeon choice of biopsy approach (trans-vitreal vs. trans-scleral) was found to associate with both tumor location and tumor thickness. A trans-scleral rather than trans-vitreal approach was used more commonly for anteriorly located tumors (92% vs. 38% of posterior tumors, p < 0.001) and thicker tumors (86% vs. 55% of thin tumors, p < 0.001). When performing trans-vitreal biopsies, ocular oncologists with previous vitreoretinal surgery fellowship training were more likely to use wide-field surgical viewing systems, compared with indirect ophthalmoscopy (82.6% vs. 20.6%, p < 0.001). Surgical complications were rare and occurred more frequently with trans-vitreal biopsies (3.6% vs. 0.46%, p = 0.046). CONCLUSIONS: In this multi-center analysis of UM tumor biopsy, surgical yield was high for obtaining tumor tissue for GEP and cytopathology analysis with both trans-scleral and trans-vitreal techniques. Fellowship-trained ocular oncologists' preferred intraocular biopsy techniques associated strongly with tumor location, tumor thickness, and fellowship training of the surgeon. Short-term complication rates were low.
PURPOSE: To investigate the relationship between surgical approach for intraocular tumor biopsy of uveal melanoma and tumor morphologic features such as size and intraocular location and the effect of these variables on diagnostic yield and biopsy outcome. METHODS: Consecutive patients from nine Ocular Oncology centers with uveal melanoma (UM) undergoing tumor biopsy immediately preceding I125 plaque brachytherapy with tissue sent for gene expression profiling (GEP) testing were reviewed retrospectively. RESULTS: Three hundred sixty patients were included (50% men, mean age 60.2 years). Overall biopsy yield was 99% and 83% for GEP and cytopathology, respectively. Surgeon choice of biopsy approach (trans-vitreal vs. trans-scleral) was found to associate with both tumor location and tumor thickness. A trans-scleral rather than trans-vitreal approach was used more commonly for anteriorly located tumors (92% vs. 38% of posterior tumors, p < 0.001) and thicker tumors (86% vs. 55% of thin tumors, p < 0.001). When performing trans-vitreal biopsies, ocular oncologists with previous vitreoretinal surgery fellowship training were more likely to use wide-field surgical viewing systems, compared with indirect ophthalmoscopy (82.6% vs. 20.6%, p < 0.001). Surgical complications were rare and occurred more frequently with trans-vitreal biopsies (3.6% vs. 0.46%, p = 0.046). CONCLUSIONS: In this multi-center analysis of UMtumor biopsy, surgical yield was high for obtaining tumor tissue for GEP and cytopathology analysis with both trans-scleral and trans-vitreal techniques. Fellowship-trained ocular oncologists' preferred intraocular biopsy techniques associated strongly with tumor location, tumor thickness, and fellowship training of the surgeon. Short-term complication rates were low.
Authors: Michael D Onken; Lori A Worley; Devron H Char; James J Augsburger; Zelia M Correa; Eric Nudleman; Thomas M Aaberg; Michael M Altaweel; David S Bardenstein; Paul T Finger; Brenda L Gallie; George J Harocopos; Peter G Hovland; Hugh D McGowan; Tatyana Milman; Prithvi Mruthyunjaya; E Rand Simpson; Morton E Smith; David J Wilson; William J Wirostko; J William Harbour Journal: Ophthalmology Date: 2012-04-21 Impact factor: 12.079
Authors: Dilraj S Grewal; Paramjit K Bhullar; Neel D Pasricha; Oscar M Carrasco-Zevallos; Christian Viehland; Brenton Keller; Liango Shen; Joseph A Izatt; Anthony N Kuo; Cynthia A Toth; Prithvi Mruthyunjaya Journal: Retina Date: 2017-04 Impact factor: 4.256
Authors: Jeremy P M Flanagan; Michael Ng; Awet Z Kibrom; Robin J A Filshie; Richard J Stawell; Roderick F O'Day Journal: J Ophthalmic Inflamm Infect Date: 2022-03-05