1. Consensus Recommendations for the Diagnosis of Vitreoretinal Lymphoma
- Author
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Denise Carbonell, Rupesh Agrawal, H. Nida Sen, Daniel Vitor Vasconcelos-Santos, Mamta Agarwal, Elisabetta Miserocchi, Sarah E. Coupland, Jacob Pe'er, Luca Cimino, Manabu Mochizuki, James T. Rosenbaum, Tracy T. Batchelor, Manfred Zierhut, Alejandra de-la-Torre, Massimo Accorinti, Bianka Sobolewska, Sarakshi Mahajan, Justine R. Smith, Soon-Phaik Chee, Tanja Bülow, Zohar Habot-Wilner, Helmut Sitter, Michael Simion, Vishali Gupta, Shahar Frenkel, Thomas Ness, Jennifer E. Thorne, Jose S. Pulido, Michal Kramer, Nicholas P Jones, Ninette H. ten Dam-van Loon, and Jyotirmay Biswas
- Subjects
Delphi Technique ,Lymphoma ,genetic structures ,diagnosis ,DNA Mutational Analysis ,Myeloid differentiation primary response ,chemistry.chemical_compound ,0302 clinical medicine ,consensus recommendations ,Vitreoretinal lymphoma ,Biomarkers, Tumor ,Humans ,Interleukin-10 ,Interleukin-6 ,Intraocular Lymphoma ,Lymphoma, Large B-Cell, Diffuse ,Mutation, Missense ,Myeloid Differentiation Factor 88 ,Retinal Neoplasms ,Retrospective Studies ,Surveys and Questionnaires ,Vitreous Body ,Immunology and Allergy ,Tumor ,Diffuse ,medicine.anatomical_structure ,medicine.medical_specialty ,03 medical and health sciences ,Retinal pigment epithelium atrophy ,Ophthalmology ,Large B-Cell ,medicine ,Macular edema ,030203 arthritis & rheumatology ,Retina ,business.industry ,Diagnostic vitrectomy ,Retinal ,medicine.disease ,eye diseases ,Fundus autofluorescence ,chemistry ,Mutation ,030221 ophthalmology & optometry ,Missense ,business ,Biomarkers - 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.
- Published
- 2021
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