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Hyun Soo Jang, Millena G. Bittencourt, Yasir J. Sepah, Sophie Raafay, Jithin Yohannan, Abeer Akhtar, Natasha Maqsood, Rachel Annam, Hong T. Liu, Quan D. Nguyen; Spectral Domain Optical Coherence Tomography Changes in the Retina of Eyes with Intraocular Lymphoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4943.
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To evaluate the progression of morphological changes in the retinal layers of patients with intraocular lymphoma (IL) using spectral domain optical coherence tomography (SD-OCT).
Patients with intraocular involvement secondary to primary lymphoma of the central nervous system (CNS) were followed during the course of their disease, using Spectralis OCT (Heidelberg, Germany) to observe morphological changes in the retina. For each patient, representative images of the lesions were selected and graded for the presence and progression of hyperreflective (HR) signals in each layer, macular edema (ME), pigment epithelial detachment (PED), and subretinal fluid (SRF) by two graders. Disagreements between the two graders were resolved by a senior grader.
4 eyes of 4 Caucasian patients (3 male, 1 female, mean age 68 years) with biopsy proven B-cell lymphoma with concurrent or previous CNS involvement were followed for 5.0 (±2.2) months. All 4 patients were treated with both systemic methotrexate and rituximab after cytological diagnosis had been made. In addition, patient 3 was given one intravitreal methotrexate injection.At baseline, all patients had HR signals that possibly indicate infiltrates in both inner and outer retina (IR and OR), including the photoreceptor layer. Patients 1 and 4 had ME. Patients 2 and 4 had PED that remained stable throughout the later visits.During follow-up visits 8.9 (±5.3) weeks after baseline, the number and intensity of HR signals increased in 3 of 4 patients. In patient 4, ME and abnormal HR signals decreased after a diagnostic vitrectomy.11 (±4.6) weeks after the follow-up (21 weeks after the first treatment for patient 3 and 4.6 (±2.4) weeks for the others), all patients had been started on systemic treatment. Patient 1 developed SRF. Patient 2 showed no change. Patient 3 had a substantial increase in HR signals in OR. Patient 4 no longer had ME.29 weeks after the first treatment, patient 3 had further increase in HR signals and PED despite the continual systemic treatment.
SD-OCT of eyes with IL can be characterized by HR signals, PED, and ME. HR signals may increase with disease activity. Thus, SD OCT may be employed to monitor the progression of IL.
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