Department of Ophthalmology, Eye and ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
BMC Ophthalmol. 2022 Sep 20;22(1):375. doi: 10.1186/s12886-022-02604-7.
To identify retinal changes using spectral-domain optical coherence tomography (SD-OCT) and ultra-widefield images in eyes with primary vitreoretinal lymphoma (PVRL) during intravitreal methotrexate (MTX) treatment. METHODS: This study retrospectively reviewed 111 eyes of 58 patients with vitreous cytology-proven confirmed PVRL, who received intravitreal injections of MTX.
At the initial visit, the OCT manifestations included vitreous cells (105 eyes, 94.6%), intraretinal infiltration (44 eyes,39.6%), subretinal infiltration (45 eyes, 40.5%,), retinal pigment epithelium (RPE) abnormalities (66 eyes, 59.5%), disruption of the ellipsoid zone (58 eyes, 52.3%), subretinal fluid (4 eyes, 3.6%), RPE detachment (PED) (28 eyes, 25.2%), epiretinal membrane (ERM) (8 eyes, 7.2%), macular edema (10 eyes, 9%). After therapy, tumor regression was achieved in all eyes. Between the initial presentation and regression, the vitreous cells (94.6% vs. 0%, P < 0.001), intraretinal infiltration (39.6% vs. 0%, P < 0.001), RPE abnormalities (59.5% vs.19.8%, P < 0.001), PED (25.2% vs.0%, P < 0.001), and subretinal infiltration (40.5%vs.16.2%, P < 0.001) were significantly reduced. The fundus photography findings all improved after therapy. The mean Logarithm of the Minimum Angle of Resolution (logMAR) for the best corrected visual acuity (BCVA) at presentation was 0.79 ± 0.81 (range, 0-2.9), which improved to 0.70 ± 0.97 (range, 0-2.9, P = 0.01) at the final visit.
SD-OCT combined with ultra-widefield imaging, which can reflect retinal changes, are valuable tools for monitoring the effect of PVRL treatment.
使用频域光相干断层扫描（SD-OCT）和超广角图像识别原发性玻璃体视网膜淋巴瘤（PVRL）眼在玻璃体内甲氨蝶呤（MTX）治疗期间的视网膜变化。
本研究回顾性分析了 58 例经玻璃体细胞学证实的 PVRL 患者 111 只眼，这些患者均接受了玻璃体内 MTX 注射。
初次就诊时，OCT 表现包括玻璃体细胞（105 只眼，94.6%）、视网膜内浸润（44 只眼，39.6%）、视网膜下浸润（45 只眼，40.5%）、视网膜色素上皮（RPE）异常（66 只眼，59.5%）、椭圆体带中断（58 只眼，52.3%）、视网膜下积液（4 只眼，3.6%）、RPE 脱离（PED）（28 只眼，25.2%）、视网膜内膜（ERM）（8 只眼，7.2%）、黄斑水肿（10 只眼，9%）。治疗后，所有眼肿瘤均消退。在治疗前和消退期间，玻璃体细胞（94.6% vs. 0%，P<0.001）、视网膜内浸润（39.6% vs. 0%，P<0.001）、RPE 异常（59.5% vs. 19.8%，P<0.001）、PED（25.2% vs. 0%，P<0.001）和视网膜下浸润（40.5% vs. 16.2%，P<0.001）均显著减少。治疗后眼底摄影结果均改善。最佳矫正视力（BCVA）的最小角分辨率（logMAR）的平均 Log 为 0.79±0.81（范围，0-2.9），最终就诊时提高至 0.70±0.97（范围，0-2.9，P=0.01）。
SD-OCT 结合超广角成像可以反映视网膜变化，是监测 PVRL 治疗效果的有价值的工具。
