Optical coherence tomography features in vitreoretinal lymphoma compared with non-infectious uveitis

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Vitreoretinal lymphoma (VRL) is a rare intraocular malignancy.
• VRL diagnosis is challenging due to non-specific symptoms mimicking uveitis.
• Spectral domain optical coherence tomography (SD-OCT) aids in characterizing VRL.

Purpose of the Study:

• To identify specific SD-OCT features differentiating VRL from uveitis.
• To compare OCT findings in VRL versus intermediate uveitis and sarcoid posterior uveitis.

Main Methods:

• Retrospective review of 56 patients with biopsy-proven VRL and 45 patients with uveitis (intermediate or sarcoid posterior).
• Analysis of SD-OCT images at initial presentation.
• Comparison of OCT features between VRL and uveitis groups.

Main Results:

• VRL patients showed more preretinal deposits, intraretinal infiltrates, inner retinal hyperreflective spots, outer retinal atrophy, subretinal deposits, RPE changes, and sub-RPE deposits.
• Uveitis patients more frequently exhibited epiretinal membrane (ERM), central macular thickening, cystoid macular edema, subretinal fluid, and subfoveal fluid.
• Absence of ERM and central macular thickening were significantly associated with VRL.

Conclusions:

• SD-OCT reveals distinct features differentiating VRL from uveitis.
• Absence of ERM and central macular thickening are highly predictive of VRL.
• SD-OCT is a valuable tool for the early diagnosis of VRL.