Interleukin 10 in Aqueous Humor for the Diagnosis of Primary Intraocular Lymphoma (PIOL)

Abstract

Abstract: : Purpose:To evaluate the diagnosis value of IL–10 level in the aqueous humor and in the vitreous body for the diagnosis of PIOL. Methods:A prospective study was conducted from 1997 to 2000 including all the patients affected by an uveitis and that underwent a vitreoretinal surgery for diagnosis or therapeutic purpose. In all these patients, an IL–10 dosage was systematically performed in aqueous humor (HA) after an anterior chamber tap and in 0.1 ml of pure vitreous (PV) collected during the same procedure at the beginning of the surgery. In all the patients, the vitreous was analyzed and a systemic work–up was performed according to clinical suspicion. Two groups of patients were retrospectively formed and compared. IL–10 levels from 44 patients with proven PIOL were compared to 52 patients with an uveitis from different etiologies. Results:Mean IL–10 level in HA was 571.50 pg/ml (range 8–1500 pg/ml) for PIOL patients and 28.79 pg/ml (range 3–375 pg/ml) for uveitis patients (p<0.005). In PV mean IL–10 level was 2135.86 pg/ml (range 22–5120 pg/ml) in PIOL group and 31.71pg/ml (range 0.5–400 pg/ml) for uveitis group (p<0.005). In AH for an IL–10 level of 100 pg/ml, sensitivity of the test was of 80.55% and specificity of 94%, kappa =5.20. In PV sensitivity was 89.47% and specificity was 91.50%, kappa=8.74. False positives are encountered in 3 cases of viral necrosis and in one case of ocular toxoplasmosis. False negatives were seen for patients affected by PIOL with very few cells in the vitreous. Conclusions:IL–10 values are a real diagnostic tool for the diagnosis of PIOL. Il–10 levels of more than 100 pg/ml in aqueous humor give a high suspicion of malignancy and can recommend the patient for a diagnostic vitrectomy. The Il–10 dosage in the vitreous is also useful and can help the cytologist to use expensive molecular technology to search clonality if cytology cannot demonstrate lymphomatous cells.

Keywords: anterior chamber • vitreoretinal surgery • inflammation