Leavitt J A, Campbell R J
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Eye (Lond). 1998;12 ( Pt 6):959-62. doi: 10.1038/eye.1998.248.
Sarcoidosis is a multi-system disease that often affects ocular structures. The definitive diagnosis of sarcoidosis requires tissue biopsy for confirmation. Conjunctival biopsy is a simple and relatively inexpensive diagnostic tool. This study was undertaken to determine the utility and cost of conjunctival biopsy for the diagnosis of sarcoidosis compared with other diagnostic biopsy sites.
A retrospective study was performed of all conjunctival biopsies taken for sarcoidosis at the Mayo Clinic Rochester between 1982 and 1995. All case histories were reviewed. Data regarding biopsy of tissues confirming sarcoidosis was collected. The costs of performing and evaluating all biopsy techniques were obtained from the estimating department.
Forty-one cases of sarcoidosis were identified that had undergone conjunctival biopsies. Twenty-one patients had a positive conjunctival biopsy for sarcoidosis, and 20 patients had a negative conjunctival biopsy but a positive biopsy of another organ. In all positive biopsies, special stains for acid fast organisms and fungi were negative.
Conjunctival biopsy is a simple, relatively inexpensive procedure that may be helpful in establishing the diagnosis of sarcoidosis with a negligible complication rate. Positive results are similar for conjunctival biopsy and mediastinoscopy. About 10 patients can be evaluated with conjunctival biopsy for the cost of one patient undergoing mediastinoscopy. Multiple levels of the tissue must be examined, as distribution of the granulomas may be random. Also, bilateral conjunctival specimens should be obtained to increase the positive yield.
结节病是一种常累及眼部结构的多系统疾病。结节病的确切诊断需要组织活检来证实。结膜活检是一种简单且相对廉价的诊断工具。本研究旨在确定与其他诊断性活检部位相比，结膜活检在结节病诊断中的实用性和成本。
对1982年至1995年在罗切斯特梅奥诊所进行的所有用于结节病诊断的结膜活检进行回顾性研究。回顾了所有病例记录。收集了关于确诊结节病的组织活检数据。所有活检技术的操作和评估成本从估算部门获取。
共确定41例结节病患者接受了结膜活检。21例患者结膜活检结节病呈阳性，20例患者结膜活检阴性，但其他器官活检呈阳性。在所有阳性活检中，抗酸菌和真菌的特殊染色均为阴性。
结膜活检是一种简单、相对廉价的操作，可能有助于结节病的诊断，并发症发生率可忽略不计。结膜活检和纵隔镜检查的阳性结果相似。结膜活检评估约10名患者的成本与一名患者进行纵隔镜检查的成本相当。必须检查组织的多个层面，因为肉芽肿的分布可能是随机的。此外，应获取双侧结膜标本以提高阳性率。
