Consensus Recommendations for the Diagnosis of Vitreoretinal Lymphoma

To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL). Literature was reviewed for reports supporting the diagnosis of VRL. A questionnaire (Delphi 1 round) was distributed to 28 participants. In the second round (Delphi 2), items of the questionnaire not reaching consensus (75% a...

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Hauptverfasser: Carbonell, Denise, Mahajan, Sarakshi, Chee, Soon-Phaik, Sobolewska, Bianka, Agrawal, Rupesh, Bülow, Tanja, Gupta, Vishali, Jones, Nicholas P., Accorinti, Massimo, Agarwal, Mamta, Batchelor, Tracy, Biswas, Jyotirmay, Cimino, Luca, Loon, Ninette H. tenDam-van, de-la-Torre, Alejandra, Frenkel, Shahar, Pe’er, Jacob, Kramer, Michal, Miserocchi, Elisabetta, Mochizuki, Manabu, Ness, Thomas, Rosenbaum, James T., Sen, H. Nida, Simion, Mr. Michael, Sitter, Helmut, Vasconcelos-Santos, Daniel V., Habot-Wilner, Zohar, Coupland, Sarah E., Pulido, José S., Smith, Justine, Thorne, Jennifer E., Zierhut, Manfred
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Sprache:eng
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Zusammenfassung:To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL). Literature was reviewed for reports supporting the diagnosis of VRL. A questionnaire (Delphi 1 round) was distributed to 28 participants. In the second round (Delphi 2), items of the questionnaire not reaching consensus (75% agreement) were discussed to finalize the recommendations. Presenting symptoms include floaters and painless loss of vision, vitreous cells organized into sheets or clumps. Retinal lesions are usually multifocal creamy/white in the outer retina. Other findings include retinal lesions with “leopard-skin” appearance and retinal pigment epithelium atrophy. Severe vitreous infiltration without macular edema is the most likely presentation. Diagnostic vitrectomy should be performed. Systemic corticosteroid should be discontinued at least 2 weeks before surgery. An interleukin (IL)-10:IL-6 ratio > 1, positive mutation for the myeloid differentiation primary response 88 gene and monoclonality are indicators of VRL. Multi-modal imaging (optical coherence tomography, fundus autofluorescence) are recommended. A consensus meeting allowed the establishment of recommendations important for the diagnosis of VRL.
DOI:10.6084/m9.figshare.14618447