How to handle ophthalmic biopsy specimen to optimize the results

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Abstract

Ophthalmic biopsies are performed for diagnostic & increasingly for prognostic purposes. The aim of the presentation is to provide “tips and tricks” for the surgeon, ophthalmic technician and pathologist in the work-up of the typical and the “atypical” ophthalmic biopsy. The Liverpool Ocular Oncology Centre is one of three referral centres for adult ocular oncology in the UK. It receives close to 800 new referrals each year, with some of these being quite unusual cases. Contrary to practice in some centres, where there is a suspicion of choroidal metastasis of an underlying (possibly unknown) systemic tumour, an intraocular biopsy is performed as one of the initial investigations to confirm (or refute) the clinical impression. Morphological and immunocytological analysis can confirm the diagnosis and provide an indication of the site of the primary tumour. Further, genetic analysis of the tumour cells (e.g. EGF-R mutations) may enable treatment choice. In the case of clear clinical diagnoses, biopsies are performed for prognostication purposes: e.g. in uveal melanoma. Close collaboration is required between surgeon and the pathology laboratory, in order to obtain the best diagnostic and prognostic yields from these samples.

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