Saito Teiko, Ohguro Nobuyuki, Iwahashi Chiharu, Hashida Noriyasu
Department of Ophthalmology, Japan Community Health Care Organization Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka City, 553-0003, Japan.
Department of Ophthalmology, Osaka University Medical School, 2-2 Yamadaoka E7, Suita, Osaka, 565-0871, Japan.
Graefes Arch Clin Exp Ophthalmol. 2016 Dec;254(12):2319-2326. doi: 10.1007/s00417-016-3395-x. Epub 2016 Jun 1.
Primary vitreoretinal lymphoma (PVRL), a subset of primary central nervous system lymphoma (PCNSL), is a high-grade malignant tumor that shows various chorioretinal findings. Optical coherence tomography (OCT) is useful for detecting these lesions, and various abnormalities on OCT images have been reported. The purpose of this report was to investigate retrospectively the OCT manifestations of various disease stages and compare the manifestations of pretreatment, recurrent, and chronic cases.
We reviewed the medical charts and OCT images of 38 consecutive cases with PVRL. When abnormalities were detected on OCT images, the patients were classified based on the treatment of the primary disease: pretreatment if not treated, recurrent if treated previously, and chronic when chronic changes.
Twenty-six eyes (20 cases) had abnormalities in the post-pole OCT images, i.e., 16 eyes (12 cases) were in the pretreatment group, seven eyes (five cases) were in the recurrent group, and five eyes (five cases) were in the chronic group. Two eyes (two cases) had abnormalities on OCT in the pretreatment and recurrent or chronic stages. The pretreatment and recurrent groups had subretinal or retinal pigment epithelium (RPE) level abnormalities more often than intraretinal changes. Twelve of 16 pretreated eyes and all seven eyes with recurrent disease had subretinal or RPE level abnormalities. One pretreatment case and three recurrent cases had atypical OCT manifestations of intraretinal (round lesions) or epiretinal changes (villous-shaped lesions).
Although pretreatment cases and recurrent cases showed similar OCT abnormalities and the specific changes in the various disease stages were unclarified, collecting OCT data from various disease stages will facilitate detection of typical OCT changes of PVRL and lead to early diagnosis and treatment.
原发性玻璃体视网膜淋巴瘤（PVRL）是原发性中枢神经系统淋巴瘤（PCNSL）的一个亚型，是一种高级别恶性肿瘤，可表现出多种脉络膜视网膜病变。光学相干断层扫描（OCT）有助于检测这些病变，并且已有多种OCT图像异常的报道。本报告的目的是回顾性研究不同疾病阶段的OCT表现，并比较治疗前、复发和慢性病例的表现。
我们回顾了38例连续性PVRL患者的病历和OCT图像。当在OCT图像上检测到异常时，根据原发性疾病的治疗情况对患者进行分类：未治疗者为治疗前，既往接受过治疗者为复发，出现慢性改变者为慢性。
26只眼（20例）在后极部OCT图像上出现异常，即16只眼（12例）在治疗前组，7只眼（5例）在复发组，5只眼（5例）在慢性组。2只眼（2例）在治疗前及复发或慢性阶段OCT出现异常。治疗前组和复发组视网膜下或视网膜色素上皮（RPE）层异常比视网膜内改变更常见。16只治疗前眼中的12只以及所有7只复发病例的眼睛均有视网膜下或RPE层异常。1例治疗前病例和3例复发病例有视网膜内（圆形病变）或视网膜前改变（绒毛状病变）的非典型OCT表现。
尽管治疗前病例和复发病例显示出相似的OCT异常，且不同疾病阶段的具体变化尚不清楚，但收集不同疾病阶段的OCT数据将有助于检测PVRL的典型OCT变化，并有助于早期诊断和治疗。
