Consensus Recommendations for the Diagnosis of Vitreoretinal Lymphoma. (3rd April 2021)

• Record Type: Journal Article
• Authors: 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; tenDam-van Loon, Ninette H.; de-la-Torre, Alejandra; Frenkel, Shahar; Pe'er, Jacob; Kramer, Michal; Miserocchi, Elisabetta; Mochizuki, Manabu; Ness, Thomas; Rosenbaum, James T.; Sen, H. Nida; Simion, Michael; Sitter, Helmut; Vasconcelos-Santos, Daniel V.; Habot-Wilner, Zohar; Coupland, Sarah E.; Pulido, José S.; Smith, Justine; Thorne, Jennifer E.; Zierhut, Manfred;
• Is Part Of: Ocular immunology and inflammation. Volume 29:Number 3(2021)
• Page Start: 507
• Page End: 520
• Publication Date: 2021-04-03
• Subjects: Vitreoretinal lymphoma -- consensus recommendations -- diagnosis; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2021.1878233
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose: To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL). Methods: 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. Results: 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. Conclusions: A consensus meeting allowed the establishment of recommendations important for the diagnosis of VRL.