Primary vitreoretinal lymphoma: empowering our clinical suspicion.

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TitlePrimary vitreoretinal lymphoma: empowering our clinical suspicion.
Publication TypeJournal Article
Year of Publication2019
AuthorsTakhar JS, Doan TA, Gonzales JA
JournalCurr Opin Ophthalmol
Date Published2019 Nov
KeywordsEye Neoplasms, Humans, Intraocular Lymphoma, Molecular Diagnostic Techniques, Myeloid Differentiation Factor 88, Retinal Neoplasms, Vitreous Body

PURPOSE OF REVIEW: Vitreoretinal lymphoma (VRL) is well known as a masquerade syndrome. However, delays in diagnosis are common particularly because of the small volume of tissue that is used for investigative studies. We outline the current diagnostic tests available to clinicians and provide a glimpse of possible future novel diagnostics.

RECENT FINDINGS: The use of spectral domain ocular coherence tomography to identify subretinal lesions has proven to be a reliable ally to clinicians. Nevertheless, the diagnostic gold standard remains cytology, which requires a skilled pathologist. Molecular tests, including MYD88 polymerase chain reaction testing has further refined our diagnostic capabilities. Metagenomic deep sequencing is a newer molecular test that offers the ability to identify any mutation associated with lymphoma development and may offer more sensitive testing in the future.

SUMMARY: Clinicians have developed a strong acumen for suspecting VRL based upon clinical features, which can further be supported by a variety of imaging modalities. Delays in diagnosis continue to occur particularly because of the small volume of ocular fluid available for testing and because current tests offer a biased approach in terms of limited scope of detecting a specific mutation or cytopathologic feature(s). Newer molecular techniques feature an expanded scope of detecting any mutation associated with lymphomatous development.

Alternate JournalCurr Opin Ophthalmol
PubMed ID31589186