ISSN 2398-2950      

Eye: paracentesis (aqueous)

ffelis

Synonym(s): Centesis


Introduction

  • Analysis of aqueous may be helpful in evaluating the eye and in diagnosis.

Uses

  • Investigation of hypopyon or uveitis , rarely used now due to stimulation of further inflammation, most samples have very few cells present. Requires careful case selection.
  • Bacterial and viral culture, again rarely used, most uveitis has sterile aqueous. Vitreous more usually used in cases of endophthalmitis.
  • Comparison of aqueous humor Toxoplasma antibodies Toxoplasma antibody titer (C-value or Coldmann-Witme coefficient) compared with systemic titers to diagnose ocular Toxoplasmosis .
  • Examination of neoplastic exfoliative cells, again beware making situation worse for little benefit.
  • Protein electrophoresis , requires comparison with serum for maximal diagnostic benefit.
  • Cytology smears will be improved by use of millipore filtration or cytospin centrifugation.
  • Immediate reduction of intraocular pressure.

Advantages

  • Easy technique, with little equipment needed. technique may be used to flush inflammatory debris from anterior chamber.

Disadvantages

  • Diagnostic potential rarely outweighs stimulation of uveitis, trauma to the front of the eye possible with poor technique.
  • Possibility of intraocular infection.
  • Trauma to cornea, iris, anterior lens.
  • Possible sequelae include:
  • Hyphema Hyphema.
  • Glaucoma Glaucoma.
  • Bacterial/fungal inoculation of anterior chamber.
  • Foreign body inoculation.
  • Fibrinous membrane formation.
  • Seeding of neoplasia to outflow tract.

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Linn‐Pearl R N, Powell R M, Newman H A & Gould D J (2015) Validity of aqueocentesis as a component of anterior uveitis investigation in dogs and cats. Vet Ophthalmol 18, 326-334 PubMed doi:10.1111/vop.12245.
  • Wiggans K T, Vernau W, Lappin M R, Thomasy S M & Maggs D J (2014) Diagnostic utility of aqueocentesis and aqueous humor analysis in dogs and cats with anterior uveitis. Vet Ophthalmol 17,  212-220 PubMed doi:10.1111/vop.12075 .
  • Lappin M R, Burney D M, Dow S W et al (1996) Polymerase chain reaction for the detection of Toxoplasma gondii in aqueous humour of cats. Am J Vet Res 57 (11), 1589-93 PubMed.

Other sources of information

  • Gelatt K N (1991) Ophthalmic examination and diagnostic procedures. In:Veterinary Ophthalmology2nd Ed. Philadelphia: Lea and Febiger p.195.

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