Vertical Hyperreflective Lesions on Optical Coherence Tomography in Vitreoretinal Lymphoma.

ABSTRACT

Importance Vitreoretinal lymphoma is a diagnostic challenge and the pathophysiology is still unclear. Objective: To describe an imaging finding seen on optical coherence tomography (OCT) of patients with vitreoretinal lymphoma. Design, Setting, and Participants: This case series study was a retrospective medical record review of patients who received a diagnosis of vitreoretinal lymphoma at the Department of Ophthalmology at Northwestern University between July 2014 and January 2016. Main Outcomes and Measures: Optical coherence tomography findings in vitreoretinal lymphoma. Results: We identified 7 patients (4 women [57.1%]; mean [range] age, 62.4 [45-75] years; 12 eyes) with intraocular lymphoma involving the retina (5 patients [71.4%] with primary vitreoretinal or central nervous system lymphoma with ocular involvement, 1 patient [14.3%] with testicular lymphoma with secondary central nervous system lymphoma and vitreoretinal lymphoma, and 1 patient [14.3%] with secondary vitreoretinal lymphoma). We identified vertical hyperreflective lesions that showed moderate or high reflectivity and affected all layers of the neuroretina in 5 patients (7 of 12 eyes [58.3%]). These often preceded the development of subretinal pigment epithelial deposits and were often localized around second-order and third-order retinal vessels. In most cases, they resolved with minimal or no scarring after the initiation of chemotherapy. Conclusions and Relevance Vertical hyperreflective lesions are a common physical finding on OCT in eyes with vitreoretinal lymphoma.