Abstract
Purpose :
In this study, we validate the effectiveness of the ISOLD score in classifying primary vitreoretinal lymphoma (PVRL) vs. uveitis in an independent single-center retrospective cohort.
Methods :
Patient diagnoses of PVRL vs. uveitis and associated aqueous and/or vitreous IL-6 and IL-10 levels were retrospectively collected. From this data, cytokine levels were compared between diagnoses with the Mann-Whitney U test. ROC curves were plotted and AUCs were calculated for the ISOLD score. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated at the ISOLD score's optimal cut-off as determined by the maximal Youden index.
Results :
79 lymphoma (10 aqueous, 69 vitreous) and 84 uveitis patients (19 aqueous, 65 vitreous) between 10/5/1999 and 9/16/2015 were included in the study. IL-6 was higher in uveitis vs. lymphoma patients while IL-10 was higher in lymphoma vs. uveitis patients (p <0.01 for all). The ISOLD score achieved an AUC of 97.8%. At the optimal cut-off as determined by the maximal Youden index; sensitivity was 94.2%, specificity was 96.9%, positive predictive value was 97.0%, and negative predictive value was 94.0%.
Conclusions :
The ISOLD score’s strong classification performance and generalizability to our independent patient cohort—comparable to the 92% accuracy, 93% sensitivity, and 95% specificity achieved in the original ISOLD study—as well as its ability to improve further with more data suggest a promising step forward in intraocular cytokine analysis for the early diagnosis of primary vitreoretinal lymphoma. Further validation studies are merited.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.