Multimodal Imaging of Vitreoretinal Lymphoma

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Vitreoretinal lymphoma (VRL) is a rare intraocular malignancy.
• Accurate diagnosis of VRL is crucial for timely treatment and improved patient outcomes.

Purpose of the Study:

• To characterize and determine the prevalence of fundus abnormalities in VRL using multimodal imaging.
• To evaluate the utility of various imaging modalities in detecting VRL-associated retinal changes.

Main Methods:

• Retrospective review of patient charts and multimodal imaging studies for VRL diagnosis.
• Analysis of findings from near-infrared reflectance, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT).

Main Results:

• All 10 VRL patients (14 eyes) exhibited vitreitis, hyperreflective lesions (NIR), and hypoautofluorescent lesions (FAF).
• Common findings included hypofluorescent lesions (FA, 79%), hypocyanescent lesions (ICGA, 77%), and retinal pigment epithelium detachments (PEDs) on OCT (71% small, 36% large).
• Outer retinal layer nodularity was observed in 93% of cases on OCT, correlating with focal PEDs and abnormal imaging signals.

Conclusions:

• Multimodal imaging reveals diverse fundus abnormalities in VRL.
• Focal PEDs and outer retinal layer nodularity on OCT are significant indicators of lymphomatous infiltration.
• Integrated use of multimodal imaging modalities can facilitate early and accurate diagnosis of VRL.