Abstract
Purpose :
To investigate the significance of regulatory T cells (Treg) and programmed cell death 1(PD-1)+cytotoxic T cells (CTL) in the vitreous of patients with intraocular lymphoma (IOL) and uveitis.
Methods :
This study involved 43 IOL and uveitis patients [11 males and 32 females; median age: 72 years (range: 51-86 years)] who underwent vitrectomy at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan from December 2019 to September 2023. All patients underwent intraocular lymphocyte surface antigen analysis via flow cytometry, and the proportion of Treg in CD4+T lymphocytes and PD-1+CTL in CD8+T lymphocytes was measured. The Steel-Dwass test and receiver operating characteristic (ROC) curve analysis was used for statistical analysis.
Results :
f the 43 cases, the causative disease was B-cell IOL (B-IOL, 13 cases), sarcoidosis (8 cases), human herpesvirus (HHV) uveitis (6 cases), human T-cell lymphotropic virus type 1 associated uveitis (HAU, 3 cases), and other/unclassifiable uveitis (13 cases). Across those categories, the median percentages of PD-1+CTL was 96.2% in B-IOL, 61.1% in sarcoidosis, 68.2% in HHV uveitis, 62.4% in HAU, and 55.9% in other/unclassifiable uveitis. A significantly higher percentage of PD-1+CTL was found in B-IOL compared to sarcoidosis (p=0.0024), HHV (p=0.0208), and other/unclassifiable (p=0.0003). Conversely, the median Treg proportions were 1.8% in B-IOL, 8.5% in sarcoidosis, 15.7% in HHV uveitis, 48.9% in HAU, and 10.8% in other/unclassifiable uveitis, and significantly lower rates were observed in B-IOL compared to sarcoidosis (p=0.0053), HHV uveitis (p=0.0066), and other/unclassifiable uveitis (p=0.0002). However, no significant difference in the percentage of PD-1+CTL and Treg was observed between HAU and B-IOL, possibly due to the small number of HAU cases in the study (p=0.1484, 0.0787). ROC analysis of the PD-1+CTL and Treg proportions in B-IOL showed high area under the curve values of 0.977 and 0.990, respectively.
Conclusions :
Our findings indicate a high percentage of PD-1+CTL and a low percentage of Treg in B-IOL cases, and that analysis of the ratio of PD-1+CTL and Treg via flow cytometry is useful for diagnosing B-IOL.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.