Cancer Management and Research (Mar 2022)

Optical Coherence Tomography Benefits the Diagnosis and Follow-Up of Primary Central Nervous System Lymphoma with Intraocular Involvement

  • Zhou X,
  • Tian S,
  • Zhou X,
  • Shi H,
  • Li Y,
  • Xiao J,
  • Chen K,
  • Chen B,
  • Xu G,
  • Wang Q

Journal volume & issue
Vol. Volume 14
pp. 1007 – 1018

Abstract

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Xianjin Zhou,1– 3 Sha Tian,3 Xian Zhou,3 Huimin Shi,3 Yi Li,3 Jianjiang Xiao,3 Kun Chen,4 Bobin Chen,5 Gezhi Xu,1,2 Qingping Wang3 1Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, People’s Republic of China; 2Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, People’s Republic of China; 3Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 4Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 5Department of Hematology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of ChinaCorrespondence: Qingping Wang, Department of Ophthalmology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, People’s Republic of China, Email [email protected] Gezhi Xu, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, People’s Republic of China, Email [email protected]: To describe the characteristic manifestations of vitreoretinal lymphoma (VRL) with optical coherence tomography (OCT) and monitor their outcomes after treatmEnt.Patients and Methods: Patients with primary central nervous system lymphoma (PCNSL) and intraocular involvement were assigned to the VRL group. OCT manifestations were analyzed and changes in abnormalities were recorded after intravitreal methotrexate injections. OCT manifestations of PCNSL patients without intraocular involvement were analyzed as well (non-VRL group).Results: There were 48 eyes with high-quality OCT records in the VRL group, of which 19 had abnormal manifestations. The most frequent abnormality was outer retina (OR) fuzzy borders (14 of 19, 73.7%). Other abnormalities included: focal subretinal deposits (8 of 19, 42.1%), hyperreflective subretinal dots (2 of 19, 10.5%), pigment epithelium detachment (PED) (5 of 19, 26.3%), preretinal deposits (5 of 19, 26.3%), epiretinal membrane (3 of 19, 15.8%), cystoid macular edema (3 of 19, 15.8%), subretinal fluid (3 of 19, 15.8%), outer retina atrophy (2 of 19, 10.5%), unilateral optic papilledema (2 of 19, 10.5%), retinal thickening (1 of 19, 5.3%), and subretinal fibrosis (1 of 19, 5.3%). Nine eyes with retinal abnormalities were receiving regular intravitreal methotrexate. The retinal structure of seven eyes (only outer retina involved) returned to almost normal on OCT images. The remaining two eyes (with severe retinal vasculitis) showed little improvement after treatment.Conclusion: OCT is helpful for the diagnosis of PCNSL with intraocular involvement and long-term follow-up of the disease.Summary Statement: The characteristic manifestations of vitreoretinal lymphoma (VRL) with optical coherence tomography (OCT) were described and their outcomes after treatment were monitored. These findings suggested that OCT is helpful for the diagnosis of PCNSL with intraocular involvement and long-term follow-up of the disease.Keywords: intravitreal injection, methotrexate, optical coherence tomography, primary central nervous system lymphoma, vitreoretinal lymphoma

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