Spectrally Resolved (Colour-Coded) Fundus Autofluorescence Using the EIDON System in Vitreoretinal Lymphoma

This study evaluates colour-coded fundus autofluorescence (FAF) in vitreoretinal lymphoma (VRL), which still represents a diagnostic challenge because of the variety of ocular manifestations and difficulties in obtaining a definite diagnosis.

Retrospective cross-sectional analysis of consecutive patients with VRL studied with colour-coded FAF. For comparative analysis, the patients also underwent conventional blue and green fundus FAF. Detection and appearance of typical VRL lesions in macular and extramacular locations on colour-coded FAF were studied and compared with other imaging techniques, including optical coherence tomography.

We evaluated 20 eyes from 10 patients affected by VRL. The agreement among readers on the presence of VRL lesions using colour-coded FAF was excellent. Lesion-specific comparative analysis showed that retinitis-like lesions were identified in 2/2 eyes using colour-coded FAF versus 0/2 eyes using blue FAF and green FAF, while lymphomatous retinal pigment epithelium (RPE) detachments were detected in 4/4 eyes using colour-coded FAF versus 1/4 eyes using blue FAF and green FAF. The classic granular appearance was similarly detected in 13/13 eyes across all FAF modalities. Comparative analysis revealed that colour-coded FAF appeared to better delineate retinitis-like lesions and lymphomatous RPE detachments than other types of FAF. Conversely, green FAF was more informative within the macula, while colour-coded FAF was also able to detect minor fluorophores and showed RPE atrophic areas, sub-RPE deposits, and perivascular infiltrates.

Colour-coded FAF can recognize the classic features of VRL. As a complementary imaging modality, colour-coded FAF may facilitate the recognition of retinitis-like lesions, lymphomatous retinal pigment epithelium detachments, and minor fluorophores compared with other FAF types.