Neoplastic Masquerade Syndromes in Patients With Uveitis

Abstract

Purpose-To identify the demographic and clinical characteristics, along with the frequency, of neoplastic masquerade syndromes in a tertiary uveitis clinic. Design-A retrospective observational cohort.Methods-Demographic and clinical data on all patients presenting to the National Eye Institute (NEI) with uveitis between 2004-2012 were used to compare neoplastic masquerade syndromes and uveitis.Results-A total of 853 patients presenting with uveitis were identified. Of these, 21 (2.5%) were diagnosed with neoplastic masquerade syndromes. The average age at presentation of masquerade syndrome patients was 57 years (median: 55, range: 38-78), for uveitis 42 years (median: 43, range: 3-98) (p=0.0003). There were 48% females in the masquerade syndromes group, compared with 59% females in the uveitis group. African American patients represented 9% of the masquerade syndrome patients and 36% of uveitis patients (p=0.01). Mean worse eye visual acuity was 0.89 (20/160) in neoplastic masquerade syndromes, and 0.66 (20/100) in the uveitis group (p=0.21). Ninety percent of masquerade syndrome patients had posterior inflammation, compared with 63% of uveitis patients (p=0.006). Forty-eight percent of the masquerade syndrome patients had unilateral disease, compared with 27% of the uveitis patients (p=0.04). Conclusion-Patientswith neoplastic masquerade syndromes were more likely to be older, male, or non-African American and to have posterior segment inflammation and unilateral disease. Patients with masquerade syndromes also had worse visual acuity than did uveitis patients. These differences in clinical characteristics may help raise the suspicion for neoplastic masquerade syndromes.

Notch signalling suppresses regulatory T‐cell function in murine experimental autoimmune uveitis

“…EAU induction was conducted following the established method. 10,17,18 Briefly, mice were immunized with an emulsion of complete Freund's adjuvant with 2 mg/ml desiccated Mycobacterium tuberculosis (Sigma-Aldrich, St Louis, MO, USA) and 300 lg human interphotoreceptor retinoidbinding protein (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The mice received a subcutaneous injection of the emulsion (200 ll) into three sites on the lower back, followed by an intraperitoneal injection of 0Á3 lg pertussis toxin.…”

“…3 Approximately 70-90% of sight-threatening uveitis in developed countries is reported to be non-infectious. 4,5 To recreate uveitis in animals, the most commonly used model is experimental autoimmune uveoretintis (EAU). 6 In this model, autoreactive T cells activated in peripheral lymphoid organs cross the blood-retina barrier, and immune responses associated with intraocular inflammation and damage occur.…”

Autoimmune uveitis: clinical, pathogenetic, and therapeutic features

“…Thus, the term autoimmune uveitis (AU) indicates an isolated type of autoimmune uveal inflammation that can occur without other autoimmune manifestations (idiopathic autoimmune uveitis: I-AU) or in the context of a known systemic autoimmune disease (systemic disease-associated autoimmune uveitis: SDA-AU) [10]. Sometimes, mainly in elderly patients, uveitis is the first presentation of an occult malignancy (''masquerade syndrome''), e.g., a central nervous system lymphoma [11,12].…”

Delineation of Choroidal and Retinal Lesions in Posterior Uveitis by Multispectral Wide-Field Scanning Laser Ophthalmoscopy

“…7,8 Primary vitreoretinal (intraocular) lymphoma (PVRL), while rare, is the most common cause of masquerade syndrome in adults mimicking intraocular inflammation. 9 Lymphomatous cells may infiltrate the vitreous, retina, and the space underlying the retinal pigment epithelium (RPE). 10 In the current study, we investigated whether the depth of chorioretinal pathology associated with these posterior uveitides could be determined from images captured by a commercially available multispectral wide-field scanning laser ophthalmoscope (Optos, Dunfermline, Scotland).…”