Abstract
Purpose
To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL).
Methods
Literature was reviewed for reports supporting the diagnosis of VRL. A questionnaire (Delphi 1 round) was distributed to 28 participants. In the second round (Delphi 2), items of the questionnaire not reaching consensus (75% agreement) were discussed to finalize the recommendations.
Results
Presenting symptoms include floaters and painless loss of vision, vitreous cells organized into sheets or clumps. Retinal lesions are usually multifocal creamy/white in the outer retina. Other findings include retinal lesions with “leopard-skin” appearance and retinal pigment epithelium atrophy. Severe vitreous infiltration without macular edema is the most likely presentation. Diagnostic vitrectomy should be performed. Systemic corticosteroid should be discontinued at least 2 weeks before surgery. An interleukin (IL)-10:IL-6 ratio > 1, positive mutation for the myeloid differentiation primary response 88 gene and monoclonality are indicators of VRL. Multi-modal imaging (optical coherence tomography, fundus autofluorescence) are recommended.
Conclusions
A consensus meeting allowed the establishment of recommendations important for the diagnosis of VRL.
To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL).
Methods
Literature was reviewed for reports supporting the diagnosis of VRL. A questionnaire (Delphi 1 round) was distributed to 28 participants. In the second round (Delphi 2), items of the questionnaire not reaching consensus (75% agreement) were discussed to finalize the recommendations.
Results
Presenting symptoms include floaters and painless loss of vision, vitreous cells organized into sheets or clumps. Retinal lesions are usually multifocal creamy/white in the outer retina. Other findings include retinal lesions with “leopard-skin” appearance and retinal pigment epithelium atrophy. Severe vitreous infiltration without macular edema is the most likely presentation. Diagnostic vitrectomy should be performed. Systemic corticosteroid should be discontinued at least 2 weeks before surgery. An interleukin (IL)-10:IL-6 ratio > 1, positive mutation for the myeloid differentiation primary response 88 gene and monoclonality are indicators of VRL. Multi-modal imaging (optical coherence tomography, fundus autofluorescence) are recommended.
Conclusions
A consensus meeting allowed the establishment of recommendations important for the diagnosis of VRL.
| Original language | English |
|---|---|
| Pages (from-to) | 507-520 |
| Number of pages | 14 |
| Journal | Ocular Immunology and Inflammation |
| Volume | 29 |
| Issue number | 3 |
| Early online date | 3 Apr 2021 |
| DOIs | |
| Publication status | Published - 2021 |
Keywords
- Vitreoretinal lymphoma
- Diagnosis
- Consensus
- Recommendations
- consensus recommendations
- diagnosis