Fluorescein and Indocyanine Green Angiographic and Tomographic Findings in Primary Intraocular Lymphoma

Abstract

Purpose: : Primary non Hodgin’s oculo–cerebral lymphoma has a mean diagnostic delay of 20 months after the initial mainly ophthalmological symptoms. The vital prognosis is threatened through cerebral involvement present in half of cases at time of diagnosis. The goal of this study was to identify indicative angiographic and tomographic features of this disease

Methods: : From January 1999 to November 2005, the patients who underwent diagnostic vitrectomy had had fluorescein and indocyanine green angiography and optical coherence tomography before surgical time. Vitreous samplings were analysed by immunocytochemistry and immunoglobulin genes amplification. Retinal angiography and optical coherence tomography were retrospectively reviewed without knowing the final diagnosis

Results: : Of two hundred sixty six vitreous samplings analysed, 51 cases of lymphoma were diagnosed. In fluorescein angiography numerous small round hypofluorescent lesions visible at early and late phase, corresponding to white punctuate lesions seen in red free photography were statistically more frequent in the patients with lymphoma (p<0.001). Macular diffusion and vasculitis did not statistically differ between patients with lymphoma or not. In indocyanine green angiography hypofluorescent lesions appeared scarce in the patients with lymphoma. In optical coherence tomography multiple nodular hyperreflexive lesions were seen at pigment epithelium level in the two groups

Conclusions: : Retinal angiography and tomography usually performed in posterior chronic uveitis could show indicative signs that could lead more quickly in obtaining biopsies for cytologic, immunocytochemistry, molecular exams. This procedure could help to achieve earlier a suitable treatment

Keywords: uveitis-clinical/animal model • imaging/image analysis: clinical • tumors