Abstract
Purpose :
Intermediate and posterior manifestations of vitreoretinal lymphoma (VRL) are well characterized. However, there is limited information on anterior segment involvement in VRL. This study aimed to describe the anterior manifestations of VRL, and their association with molecular testing.
Methods :
Retrospective analysis of patients with biopsy-proven VRL consecutively seen at a referral center for ocular oncology and uveitis. Data from all the available visits were reviewed for each patient. Study variables included anterior segment findings, slit-lamp photos and in vivo confocal microscopy (IVCM) when available. MYD88 L265P mutation and cytology in the aqueous humor, retinal and systemic findings were also analyzed.
Results :
The analysis included ninety-seven eyes of 49 VRL patients (mean age 68±12 years; 31 females, 63%). Anterior segment involvement was present in at least one visit in 47 eyes (48%) of 28 patients (57%); it included keratic precipitates (dendritiform with branching and irregular margins in 31 eyes, dust-like in 13 eyes, and mutton fat in 12 eyes), cells in the anterior chamber (43 eyes), and posterior synechiae (2 eyes). IVCM was available for 41 eyes and showed different morphologies of keratic precipitates, including floral, spikes, and mulberry patterns (66%, 56%, and 20%, respectively). MYD88 L265P mutation in the aqueous humor was detected in 10/21 (48%) eyes with no anterior segment involvement and 24/37 (65%) eyes with anterior segment involvement (p-value = 0.3).
Conclusions :
Anterior segment manifestations can be associated with active VRL and include dendritiform and dust-like keratic precipitates. IVCM in VRL can identify different patterns associated with keratic precipitates. MYD88 L265P mutation in the aqueous humor of VRL patients can also be found in eyes with no apparent anterior segment involvement.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.