Abstract
Purpose:
The diagnosis of ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma requires a biopsy, and there are very few non-invasive clinical tests that allow for the assessment of such tumors and their post-operative progression. The purpose of this study was to investigate the validity of anterior-segment OCT (AS-OCT) for the assessment of conjunctival MALT lymphoma.
Methods:
Eleven eyes from seven patients treated at the Osaka University Hospital between March 2007 and December 2012 were used. The study protocol was approved by the Osaka University School of Medicine ethics committee, and informed consent was obtained from all patients. The ocular lesions were assessed using MRI, and cancer stage was determined using PET-CT. AS-OCT (VISANTETM-OCT, Carl Zeiss Meditec) was then used to obtain images of the conjunctival MALT lymphoma lesions, and the images were sequentially analysed.
Results:
The mean observation period was 21±20 months. All cases were stage 1E, with 3 cases (3 eyes) originating from the conjunctiva, whereas the other 4 cases (8 eyes) originated from the orbit. Upon observation of the anterior segment, the tumors presented as salmon-pink lesions in the upper half of the eye, and they occupied the subconjunctival space. Analysis using AS-OCT revealed that the MALT lymphoma lesions were structurally solid, homogenous, and continuous with the conjunctiva. AS-OCT imaging also confirmed that clinical interventions, such as surgical excision and chemotherapy, led to the regression of the ocular lesions.
Conclusions:
While the quantitative assessment and reproducibility of these results require further investigation, our findings suggest that solid, homogenous lesions may be a characteristic presentation of ocular MALT lymphomas, and that AS-OCT may be a valid, non-invasive imaging modality for the assessment of conjunctival lesions arising from MALT lymphoma.