Fundus Autofluorescence Patterns in Primary Intraocular Lymphoma

Abstract

Granularity on FAF was associated with active lymphoma in majority of the cases. An inversion of FAF (hyperautofluorescent spots on FAF corresponding to hypofluorescent spots on fluorescein angiography) was observed in less than half of the eyes.

Multimodal Imaging of Vitreoretinal Lymphoma

“…FAF typically shows areas of hyperautofluorescence corresponding to brown clumps on the tumor surface and hypoautofluorescent areas corresponding to focal RPE atrophy or VRL cells at the RPE level; this pattern appears completely reversed on FA [6,8,9,10]. In our population we confirmed these features by the presence of bright, hyperautofluorescent lesions in 100% of the patients and of hypoautofluorescent lesions in 79%.…”

“…With regard to OCT findings, we confirmed some features previously reported in case reports and secondary to lymphomatous cells infiltration. These alterations included small and large PEDs [8,9,12,13,14,15], subretinal material [12,13,16], exudative retinal detachment [17], and focal hyperreflectivity in the ONL [12]. Additionally, we were able to confirm the presence of vitreal cells in 58% of patients, and hyperreflective nodularity in the outer retinal layers in 93% of cases using SD-OCT.…”

“…Due to the high density of lymphomatous cells between the RPE and Bruch's membrane, small PEDs on OCT appeared as areas of increased reflectance on NIR reflectance imaging; similarly, they corresponded to areas of increased autofluorescence on FAF. This may be related to the presence of altered RPE metabolism over the sub-RPE cells, or to a possible intrinsic autofluorescence by malignant B-cells [8]. On the contrary, lymphomatous infiltration above the RPE may block autofluorescence from the RPE cells and create hypoautofluorescent lesions on FAF, as also suggested by other authors [6,18].…”

“…Previous authors have suggested that nodular hyperreflective lesions in the subretinal or sub-RPE space represent signs of infiltration and may disrupt the outer retinal bands physiologically present between the ONL and the RPE (fig. 4) [8,9,18,19]. Lymphomatous invasion can also occur in the form of hyperreflective bands above the RPE or even in the inner retinal layers [18,20,21].…”

Capillary Dropout: A Novel Fluorescein Angiography Finding in Primary Vitreoretinal Lymphoma

“…Diagnostic vitrectomy for cytologic analysis with immediate handling is essential for the diagnosis of VRL. In primary VRL, the most common findings were related to sub-retinal pigment epithelium lymphomatous infiltrates that created focal pigment epithelial detachments leading to abnormal near-infrared reflectance imaging, FAF, FFA, and indocyanine green angiography signals [4,5,6,7]. Velez et al [7] described the characteristic fluorescein angiographic features in primary VRL [8].…”