Fundus Autofluorescence Patterns in Primary Intraocular Lymphoma

Abstract

Purpose: : To examine the utility of fundus autofluorescence (FAF) in patients with primary intraocular lymphoma (PIOL).

Methods: : Retrospective review of patients with PIOL referred and treated at the National Eye Institute between 1994 and 2010 is performed. All patients received FAF and fluorescein angiography, color fundus images, and/or OCT. FAF images were examined for areas of abnormal hyper or hypoautofluorescence. Fluorescein angiograms (FA), color fundus images and OCTs were evaluated for correlation with FAF images.

Results: : Ten patients (19 eyes) with PIOL, both active and in remission, who had FAF testing were identified. Sixteen eyes (of 9 patients) were diagnosed with active PIOL at the time of FAF imaging, while 4 eyes (of 3 patients) were in remission. Seventy two percent (12 eyes of 7 patients) demonstrated unique patterns on FAF, all of which were noted to have active PIOL. Among those patients with notable FAF patterns, 61% of eyes (11 eyes of 9 patients) demonstrated granularity, ranging from mild to moderate amounts of alternating hypoautofluorescent and hyperautofluorescent spots in the posterior pole. These areas of hypoautofluorescence on FAF corresponded to areas of hyperfluorescence on FA and to the nodular hyperreflective spots at the level of RPE on OCT. Blockage of autofluorescence (hypoautofluorescence) by mass lesion was seen in 11% (2 eyes of 2 patients). Well-delineated areas of hypofluorescence corresponding to atrophy were seen in 28% (5 eyes of 3 patients). Normal FAF images were seen in 37% of eyes (7 eyes of 5 patients). All patients that were in remission had normal FAF images (4 eyes of 3 patients).

Conclusions: : FAF may be a useful adjunct in the diagnosis and management of active PIOL. However, it lacks specificity and one third of patients may not have abnormality.

Keywords: uveitis-clinical/animal model • tumors • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)