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.
Subject(s)
Intraocular Lymphoma/diagnosis , Lymphoma, Large B-Cell, Diffuse/diagnosis , Retinal Neoplasms/diagnosis , Vitreous Body/pathology , Biomarkers, Tumor/metabolism , DNA Mutational Analysis , Delphi Technique , Humans , Interleukin-10/metabolism , Interleukin-6/metabolism , Intraocular Lymphoma/genetics , Intraocular Lymphoma/metabolism , Lymphoma, Large B-Cell, Diffuse/genetics , Lymphoma, Large B-Cell, Diffuse/metabolism , Mutation, Missense , Myeloid Differentiation Factor 88/genetics , Retinal Neoplasms/genetics , Retinal Neoplasms/metabolism , Retrospective Studies , Surveys and Questionnaires , Vitreous Body/metabolismABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine the safety of intracameral moxifloxacin 0.5% ophthalmic solution in cataract surgery given at a dose of 500 mg/0.1 mL.<br /><strong>METHODS:</strong> Medical records of uncomplicated phacoemulsification performed between January 2009 and December 2010 were reviewed. Each eye received 0.1 mL intracameral moxifloxacin (0.5% ophthalmic solution containing 500 mg of moxifloxacin) prophylactically. Outcome measures included anterior chamber cells and flare (Hogan System), corneal thickness, endothelial cell density, visual acuity, and intraocular pressure.<br /><strong>RESULTS:</strong> 353 eyes of 244 patients, mean age of 67.51 ± 9.22 years, were included into the study. All patients completed follow-up to 3 weeks, with 79 patients (103 eyes) followed up to 3 months. All eyes had 20/40 or better vision at 3 weeks and 3 months postoperatively. Trace to +2 anterior chamber cells and flares were observed in 96% of eyes on day 1 postsurgery. All had quiet anterior chambers at subsequent follow-up examinations. Intraocular pressures recorded postoperatively were not significantly different. Mean endothelial cell count (ECC) postoperatively were 2473.25 cells/mm2 at 3 weeks and 2468.42 cells/mm2 at 3 months and were not significantly different from baseline (2586.57 cells/mm2) (p = 0.07 and 0.12 respectively). The mean central corneal thickness postoperatively at 3 weeks (551.92 µm) and at 3 months (542.67 µm ) were not different from baseline (546.48 µm) (p = 0.47). Those with diabetes mellitus showed similar results.<br /><strong>CONCLUSION:</strong> Intracameral moxifloxacin 0.5% appears to be safe for prophylactic use in cataract surgery. At a dose of 500 mg/0.1 mL, there was minimal anterior chamber reaction, and the corneal thickness and endothelial cell density were not significantly different from preoperative.</p>
