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Diagnostic procedures in vitreoretinal lymphoma.

Monica Dalal1, Megan Casady, Emily Moriarty

  • 1National Eye Institute, National Institutes of Health , Bethesda , United States .

Ocular Immunology and Inflammation
|January 1, 2014
PubMed
Summary

Diagnosing vitreoretinal lymphoma often requires multiple invasive procedures, with pars plana vitrectomy being most common. Confirmation can take over a year, highlighting the need for high clinical suspicion.

Keywords:
Biopsydiagnosismasqueradevitrectomyvitreoretinal lymphoma

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Area of Science:

  • Ophthalmology
  • Oncology
  • Pathology

Background:

  • Vitreoretinal lymphoma (VRL) is a rare and often challenging diagnosis.
  • Early recognition is crucial for timely treatment and improved patient outcomes.

Purpose of the Study:

  • To determine the types and quantity of diagnostic interventions required for confirming VRL.
  • To analyze the diagnostic yield and timelines associated with various procedures.

Main Methods:

  • Retrospective chart review of 27 patients diagnosed with VRL.
  • Analysis of diagnostic procedures including pars plana vitrectomy, vitreous tap, anterior chamber tap, chorioretinal biopsy, brain biopsy, and cerebrospinal fluid cytology.

Main Results:

  • Pars plana vitrectomy was the most frequent diagnostic procedure (48.1%).
  • A mean of 2.1 procedures were needed per patient, with 63% experiencing at least one false negative.
  • The average time from symptom onset to diagnosis was 13.9 months.

Conclusions:

  • Vitreoretinal lymphoma diagnosis is complex and necessitates a high index of clinical suspicion.
  • Multiple invasive procedures are frequently required for definitive histopathologic confirmation.
  • Diagnostic delays underscore the challenges in identifying and confirming VRL.