Download This course presents a review of common laboratory and diagnostic

This course presents a review of common laboratory and diagnostic tests to aid in the diagnosis,
treatment and management of systemic disease with ocular sequela. Common lab sets will be
emphasized for specific disease processes.
I.
Indications for Laboratory Testing
 Inflammatory Disease
 Orbital Disease
 Retinal Disease
 Optic Disc Disease

Retinal Vascular
Disease
II. Laboratory Tests
A. CBC with diff (complete blood count with differential): basic screening test
 Consists of white blood count (WBC), differential white count (diff), red blood count
(RBC), hematocrit (HCT), hemoglobin (Hgb), and red blood indices of mean
corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean
corpuscular hemoglobin concentration (MCHC)
B. ESR (erythrocyte sedimentation rate) - nonspecific test. Westergren is most reliable.
 Guideline for top normal: men = 0.5 x age, women = 0.5 x (age +10)
 Inflammatory and necrotic processes alter blood proteins making the erythrocytes
clump together and aggregate (fall quicker). Measures the degree to which
erythrocytes settle in 1 hour in a vertical tube.
C. FBS (fasting blood sugar) - detects disorder of glucose metabolism.
D. HgbA1c (glycosylated hemoglobin)
 Results expressed as a percent of total hemoglobin (blood glucose bound to
hemoglobin)
 Index of long-term glucose control for preceding 2 to 3 month period.
E. Thyroid
 T4 (total thyroxine)
 T3 (total triiodothyronine)
 TSH (thyroid stimulating hormone)
 TRH (thyrotropin-releasing hormone) stimulation test
F. Lipid profile - includes chloesterol, triglycerides, LDL, and HDL.
G. VDRL
 A screening test. Tends to become negative 6-18 months after adequate treatment.
H. RPR (rapid plasma reagin)
 A screening test. More sensitive than VDRL.
I. FTA-ABS (fluorescent treponemal antibody absorption)
 Highly sensitive, specific test - determines if a pt has or has not had systemic syphilis.
 Used in diagnosis - can confirm a positive RPR. Tends to remain positive for life.
J. ANA (antinuclear antibody)
 Detects antinucleoprotein factors associated with certain autoimmune diseases.
 Lupus, chronic hepatitis, periarteritis nodosa, dermatomyositis, scleroderma, TB,
anaplastic carcinoma or lymphoma, Raynaud's disease, and Sjögren's.
K. Eliza (enzyme-linked immunosorbent assay)
 Detects antibodies to many infectious agents. Highly sensitive and specific.
L. HLA (human leukocyte antigens)
 Histocompatability antigens present on surface of most nucleated cells.

M.
N.
O.
P.
Q.
R.
S.
T.
U.
HLA-B27: positive in 5-8% of normals, 85% of ankylosing spondylitis, Reiter's
syndrome, psoriatic arthritis, Behcet's.
RF (rheumatoid factor)
 RF are antibodies - RA, disseminated lupus, Sjögren's, chronic active hepatitis.
ACE (angiotensin-converting enzyme) - measure of granulomatous tissue in the body.
PT (prothrombin time) / PTT (partial thromboplastin time) - clotting times.
LDH (lactic acid dehydrogenase) - malignant neoplasms.
GGT (gamma glutamyl transferase)
SGOT (serum glutamic-oxaloacetic tranaminase) - metastatic carcinoma.
SGPT (serum glutamic-pyruvic transaminase)- dx liver disease (metastatic carcinoma).
ALP (alkaline phosphatase) - tumor marker and an index of liver and bone disease.
Uric acid - evaluation of renal failure, gout, and leukemia.
III. Clinical Presentations
Common
Lab Sets
Uveitis
Thyroid
CBC with diff,
ESR, ANA,
RPR, VDRL,
FAT-ABS
(lyme titer,
HLA-B27)
T3, T4,
TSH,
T3RIA,
T3RU, FT4
Index
Melanoma
LDH,
GGT,
SGOT,
SGPT,
ALP
Retinal Vein
Occlusions
FBS, CBC with
diff, lipid
profile, PT,
PTT, ANA, RF,
FTA-ABS
NFLIs
HIV Eliza,
FBS,
HgbA1c,
CBC with
diff
Swollen
Discs
CBC with
diff, ESR,
RPR,
FTA-ABS