Fardeau Christine, Lee Cheryl P L, Merle-Béral Hélène, Cassoux Nathalie, Bodaghi Bahram, Davi Frédéric, Lehoang Phuc
Department of Ophthalmology, Pitié-Salpétrière Hospital, University Paris VI, Paris, France.
Am J Ophthalmol. 2009 May;147(5):886-94, 894.e1. doi: 10.1016/j.ajo.2008.12.025. Epub 2009 Feb 25.
To determine the presence of clinicopathological correlations for primary intraocular non-Hodgkin lymphoma (NHL)in fluorescein angiographies (FA), indocyanine green (ICGA) angiographies, and optical coherence tomography (OCT) images.
Comparative retrospective interventional case series.
Institutional practice. All serial patients who underwent vitreous sampling for cytological analysis over a 70-month period were reviewed. Clinical, angiographic, and tomographic findings present prior to tissue diagnosis were re-evaluated in a masked fashion.
Cytological analysis of 256 vitreous specimens from 244 patients was performed. The final diagnoses were infections in 42 cases (17.2%) and immune-mediated diseases in 34 cases (13.9%). In 59 cases (24.2%), neoplastic disease was present, and 53 (21.7%) of these were primary intraocular NHL. OCT images showed nodular hyperreflective lesions in the retinal pigment epithelium (RPE) of both intraocular NHL and nonintraocular NHL patients. Clusters of numerous hypofluorescent small lesions revealed by FA that corresponded to punctate whitish lesions in the fundus and rare round clustered hypofluorescent lesions revealed by ICGA were associated with intraocular NHL diagnosis. The positive predictive value was 88.9% and the negative predictive value was 85%. The odds ratio risk was 45.22.
The presence of clusters of round stable hypofluorescent lesions in FA that are scarce in ICGA, with corresponding RPE hyperreflective nodular lesions on OCT, warrants obtaining biopsies for cytology, immunostaining, and molecular biology exams.
确定原发性眼内非霍奇金淋巴瘤（NHL）在荧光素血管造影（FA）、吲哚菁绿（ICGA）血管造影和光学相干断层扫描（OCT）图像中的临床病理相关性。
比较性回顾性干预病例系列。
机构实践。回顾了在70个月期间接受玻璃体采样进行细胞学分析的所有连续患者。在组织诊断之前出现的临床、血管造影和断层扫描结果以盲法重新评估。
对244例患者的256份玻璃体标本进行了细胞学分析。最终诊断为感染42例（17.2%），免疫介导疾病34例（13.9%）。59例（24.2%）存在肿瘤性疾病，其中53例（21.7%）为原发性眼内NHL。OCT图像显示眼内NHL和非眼内NHL患者的视网膜色素上皮（RPE）均有结节状高反射病变。FA显示的大量低荧光小病变簇对应于眼底的点状白色病变，ICGA显示的罕见圆形簇状低荧光病变与眼内NHL诊断相关。阳性预测值为88.9%，阴性预测值为85%。优势比风险为45.22。
FA中存在圆形稳定低荧光病变簇，ICGA中少见，且OCT上有相应的RPE高反射结节状病变，需要进行活检以进行细胞学、免疫染色和分子生物学检查。
