Retinal and Choroidal Changes of Vitreoretinal Lymphoma from Active to Remission Phase after Intravitreal Rituximab

Ocul Immunol Inflamm. 2020 May 18;28(4):637-646. doi: 10.1080/09273948.2019.1616769. Epub 2019 Aug 8.

Abstract

To identify main qualitative and quantitative changes by spectral-domain optical coherence tomography (SD-OCT) in eyes with vitreoretinal lymphoma (VRL) shifting form active to remission phase, after intravitreal rituximab (IVR).

SD-OCT scans retrospectively assessed for: hyperreflective retinal dots (HRD), intraretinal infiltration, subretinal infiltration, outer retina (OR) fuzzy borders, and pigment epithelium detachments (PED).Central macular thickness (CMT) and choroidal thickness (CT) were measured. These features were examined in active and in remission phase.

Eighteen eyes of nine patients enrolled. Patients received 5.3 ± 2.1 IVR according to a 2-weekly or monthly schedule. In remission phase, presence of HRD (p = 0.02), intraretinal infiltration (p = 0.02), OR fuzzy borders (p = 0.01) significantly reduced. Treatment frequency did not influence rate of disappearance of these features. CMT (p = 0.04) and CT (P = 0.004) became thinner.

Signs referable to lymphoma-induced inflammation (CMT, CT, HRD) and infiltration (intraretinal infiltrates, OR fuzzy borders) decreased in remission phase. Further comparative studies needed to identify the specific role of IVR in inducing these changes.

Keywords: Fundus autofluorescence; optical coherence tomography; primary vitreoretinal lymphoma; widefield imaging.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Choroid / pathology*
  • Disease Progression
  • Female
  • Fluorescein Angiography / methods
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Immunologic Factors / adverse effects
  • Intravitreal Injections
  • Lymphoma / diagnosis*
  • Lymphoma / drug therapy
  • Male
  • Middle Aged
  • Remission Induction / methods*
  • Retina / pathology*
  • Retinal Neoplasms / diagnosis*
  • Retinal Neoplasms / drug therapy
  • Retrospective Studies
  • Rituximab / administration & dosage*
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity*
  • Vitreous Body / pathology

Substances

  • Immunologic Factors
  • Rituximab