Fine-Needle Aspiration Biopsy of Intraocular Mass-Like Lesions

Objectives: The purpose of this study was to evaluate the diagnostic performance of fine-needle aspiration (FNA) biopsy for intraocular mass-like lesions and its contributing factors. Methods: Intraocular FNA cases were retrieved and reviewed along with histopathologic follow-ups, if available. The effects of rapid on-site evaluation (ROSE), repeated biopsy, and adjunct immunocytochemical studies on cytologic diagnoses were analyzed. Results: Of 72 FNA biopsies from 63 patients, nondiagnostic biopsy was seen in 17 cases ( 24%), whereas a definitive diagnosis was rendered in 39 cases ( 54%). The cytologic diagnoses correlated well with histopathologic follow-ups with a concordance rate of 61%. Almost all nondiagnostic biopsies (16/17, 94%) were seen in cases in which ROSE was not performed Of the 7 patients in whom biopsy was repeated, a definitive diagnosis was rendered in 4 cases ( 57%). Immunocytochemistry was performed in the majority of cases with a malignant diagnosis, especially in metastatic tumors (75%). Conclusions: Our data demonstrates that FNA is an effective tool for the diagnosis of intraocular tumors. ROSE, repeated biopsy, and adjunct immunocytochemistry can help reduce the nondiagnostic rate and/or enhance diagnosis of malignancy, further improving FNA diagnostic performance.