SILICONE FINE NEEDLE ASPIRATION RETINAL BIOPSY: a novel surgical technique for vitreoretinal lymphoma

To describe a technique using a 41-gauge silicone fine needle aspiration biopsy (S-FNAB) and assess its value in diagnosing primary vitreoretinal lymphoma (PVRL). Retrospective review of seven consecutive patients who underwent vitreous biopsy and 41-gauge S-FNAB of retinal/subretinal lesions in a single tertiary center between January 2012 and March 2023. Of seven patients, S-FNAB confirmed the diagnosis of PVRL in six patients. In five of those patients, both vitreous biopsy (VB) and retinal/subretinal S-FNAB (performed at the same procedure) yielded positive results, with the retinal thickness at the biopsy site as small as 231 μm. Four of these five patients had one or more previous negative VB. In one patient, S-FNAB yielded positive results despite a negative VB. S-FNAB failed to confirm positive VB for PVRL in the remaining patient. The time from symptom onset to diagnosis of PVRL ranged from 18 days to 26 months. There were no severe complications associated with the procedure. S-FNAB might be a valuable method for obtaining a sufficient sample of viable cells to diagnose PVRL. It can be performed as a primary procedure along with VB. Further studies are warranted to determine where this technique could be most advantageous.