原发性玻璃体视网膜淋巴瘤患眼光相干断层扫描图像特征

Characteristics of optical coherence tomography in patients with primary vitreoretinal lymphoma

目的观察原发性玻璃体视网膜淋巴瘤(PVRL)患眼光相干断层扫描(OCT)图像特征。方法回顾性临床研究。2016年9月至2019年10月于北京同仁医院眼科经玻璃体病理学检查确诊为PVRL的19例患者32只眼纳入研究。其中,男性7例,女性12例;中位年龄56岁;出现症状至最终平均确诊时间(6.1±3.8)个月。首诊诊断为葡萄膜炎12例(63.1%,12/19)、视网膜静脉阻塞2例(10.5%,2/19)、视网膜中央动脉阻塞1例(5.3%,1/19)、伪装综合征疑诊PVRL 4例(21.1%,4/19)。患眼均行常规眼科检查及频域OCT检查,典型图像存盘分析。根据检查结果将PVRL OCT征象分为玻璃体细胞、内层视网膜浸润、外层视网膜浸润、视网膜色素上皮(RPE)浸润、RPE下浸润、视网膜下液。结果所有患眼均可见玻璃体细胞(100.0%,32/32)。32只眼中,RPE浸润19只眼(59.4%,19/32),RPE下浸润16只眼(50.0%,16/32),外层视网膜浸润8只眼(25.0%,8/32),内层视网膜浸润16只眼(50.0%,16/32),视网膜下液4只眼(12.5%,4/32)。结论PVRL OCT征象可累及玻璃体和视网膜各解剖层次,表现为玻璃体细胞、内层视网膜浸润、外层视网膜浸润、RPE浸润、RPE下浸润及视网膜下液;且同一患者可同时显示多种征象。

Objective To observe the image characteristics of optical coherence tomography(OCT)in patients with primary vitreoretinal lymphoma(PVRL).Methods A retrospective clinical study.Thirty-two eyes of 19 patients diagnosed with PVRL by vitreous pathology in the Department of Ophthalmology,Beijing Tongren Hospital from September 2016 to October 2019 were included in this study.There were 7 males and 12 females.The median age was 56 years.The mean time from symptom onset to final diagnosis was 6.1±3.8 months.The first diagnosis was uveitis in 12 cases(63.1%,12/19),retinal vein occlusion in 2 cases(10.5%,2/19),central retinal artery occlusion in 1 case(5.3%,1/19),and suspected PVRL of camouflage syndrome in 4 cases(21.1%,4/19).Routine ophthalmic examination and frequency-domain OCT examination were performed in all the patients,and typical images were stored for analysis.According to the examination results,PVRL OCT signs were divided into vitreous cells,inner retinal infiltration,outer retinal infiltration,retinal pigment epithelial(RPE)infiltration,sub-RPE infiltration,and subretinal fluid.Results Vitreous cells were found in all eyes(100.0%,32/32).RPE infiltrated were observed in 19 eyes(59.4%,19/32),RPE infiltration in 16 eyes(50.0%,16/32),outer retinal infiltration in 8 eyes(25.0%,8/32),inner retinal infiltration in 16 eyes(50.0%,16/32),and subretinal fluid in 4 eyes(12.5%,4/32).Conclusions PVRL OCT signs can involve vitreous and retinal anatomical levels,including vitreous cells,inner retinal infiltration,outer retinal infiltration,RPE infiltration,sub-RPE infiltration and subretinal fluid.The same patient can show multiple signs at the same time.