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Mary Aronow, Craig Portell, John Sweetenham, Arun Singh; Uveal Lymphoma: Comparison of Diagnostic Imaging Studies. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5878.
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© ARVO (1962-2015); The Authors (2016-present)
To compare imaging results from fluorescein angiography (FA), indocyanine green angiography (ICG), B-scan ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) in patients with uveal lymphoma.
Data were collected regarding patient characteristics, clinical features on ophthalmic examination, and ancillary imaging studies in 16 patients (25 affected eyes) diagnosed with uveal lymphoma between 1997 and 2012.
12 patients were male (75.0%) and the median age at diagnosis was 67.5 years. Choroidal involvement was present in 15 (93.7%) and ciliochoroidal disease was present in 1 (6.3%) case. Lymphoma of overlapping ocular adnexal structures was observed in 8 cases (50.0%) including: the conjunctiva in 4 (25.0%), the orbit in 3 (17.7%), and conjunctiva and orbit in 1 (6.3%) case. Bilateral disease was present in 9 cases (56.3%). The most characteristic clinical examination finding was yellow-white choroidal infiltrates, observed in 25 (100.0%) eyes. Infiltrates were located anterior to the arcades (84.0%), most commonly in a diffuse (32.0%) or superotemporal (32.0%) distribution. FA yielded a variety of patterns including early hyperfluorescence (84.6%), hypofluorescent lesions (15.4%), choroidal folds (38.5%), and normal angiographic findings (7.7%). In contrast, ICG demonstrated hypofluorescent lesions corresponding to clinically observed infiltrates in 100% of cases. B-scan ultrasonography detected extrascleral extension (ESE) in 70% of eyes. In such cases, CT orbit detected 25.0% and MRI orbit detected 75.0% of eyes with ESE.
Ancillary imaging is essential for evaluating the full extent of ocular involvement and for treatment planning in individuals with uveal lymphoma. ICG is a superior imaging study than FA to assess choroidal lymphoma. B-scan ultrasonography is more sensitive in detecting ESE than either CT or MRI of the orbit.
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