Utility of en Face Optical Coherence Tomography in Intraocular Lymphoma

Abstract

Purpose: To report the en face optical coherence tomography (OCT) features of intraocular lymphoma.Methods: Retrospective, observational case report.Results: A 59-year-old man, a known case of primary testicular carcinoma, complained of right eye blurred vision since 1 week. He had previously undergone systemic intravenous chemotherapy (R-CHOP regimen), orchiectomy, and external beam radiotherapy for the primary malignancy. His right eye vision was 20/30, 6/6 reduced Snellen. The right eye anterior segment examination was normal. Fundus examination showed vitreous cells 1+ and a large, bumpy, subretinal dull-yellow lesion sparing the fovea with multiple discrete yellow retinal lesions at the posterior pole. Magnetic resonance imaging of the brain was normal. Multimodal imaging was used to document the clinical features. On the en face OCT, multiple hyperreflective lesions were identified on the superficial, deep, and outer retinal slabs of the scan corresponding to the vertical hyperreflective lesions extending from the retinal nerve fiber layer to the retinal pigment epithelium. The subretinal pigment epithelium lesion can be well delineated in the choriocapillaris segment. He was treated with multiple injections of intravitreal methotrexate 400 mg/0.1 mL along with systemic chemotherapy in conjunction with the oncologist. At the 6-month follow-up, fundus lesions had regressed. In addition, resolution of the lesions was noted on the OCT and en face OCT scans.Conclusion: En face OCT imaging can be considered for monitoring the therapeutic efficacy after intravitreal chemotherapy in intraocular lymphoma.

Electroretinographic and Optical Coherence Tomographic Evaluations of Eyes with Vitreoretinal Lymphoma

“…Although several studies have been published that illustrated the OCT manifestations of primary VRLs or VRLs associated with CNS lymphomas [16][17][18][19][20]24,28,29,[32][33][34][35][36][37][38][39][40][41][42][43][44][45], most of the morphologic features were nonspecific [16,32,33]. Our cases also had some of the features found in other studies; however, these features were labelled differently by different authors(Supplemental Table S1) [16][17][18][19][20]24,28,29,[32][33][34][35][36][37][38][39][40][41][42][43][44][45]. It would be better if these features are named consistently ...…”

“…OCT is an important and helpful noninvasive method in diagnosing and managing retinal diseases including VRL. Although several studies have been published that illustrated the OCT manifestations of primary VRLs or VRLs associated with CNS lymphomas [ 16 , 17 , 18 , 19 , 20 , 24 , 28 , 29 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], most of the morphologic features were nonspecific [ 16 , 32 , 33 ]. Our cases also had some of the features found in other studies; however, these features were labelled differently by different authors ( Supplemental Table S1 ) [ 16 , 17 , 18 , 19 , 20 , 24 , 28 , 29 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”