Investigating Microinvasive Intra-Ocular Biopsy.

Background: Current minimally invasive methods of intraocular biopsy are confined to small gauge (G) needles and subretinal cannulae that can be prone to wound leakage at the biopsy site. We investigate the role of microneedles with internal diameters as small as 49G for intraocular biopsy in the posterior and anterior segments.

Methods: Human uveal melanoma (UM 92-1) and retinoblastoma (Y79) cancer cell lines were aspirated using microneedles of different sizes with a vitrectomy set up, and cell viability was analysed. Suspensions of cancer cells with fluorescent microbeads were injected into the subretinal space of fresh ex vivo porcine eyes before simulating biopsy with microneedle retinal puncture, followed by imaging with optical coherence tomography (OCT) and histology. Anterior chamber puncture was performed with microneedles and imaged with anterior segment OCT and examined for aqueous leakage.

Results: We find that microneedles can aspirate ocular cancer cells, both retinoblastoma and uveal melanoma, in vitro and retain a high level of cell viability, 72.83% (49G) compared to 97.00% (25G vitrector) in UM 92-1. Using an ex vivo porcine model, we find that a 49G microneedle creates a self-sealing retinal wound that does not reflux microbeads of 200 nm in diameter. Further, we find that anterior chamber puncture with a microneedle via a corneal paracentesis results in no evidence of an aqueous leak (0%) compared to a leakage rate of 100% and 66% when using a 30G and 34G needle, respectively.

Conclusion: A microinvasive approach to biopsy intraocular specimens is feasible, warranting further in vivo studies.