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FUNDUS AUTOFLUORESCENCE PATTERNS IN PRIMARY INTRAOCULAR LYMPHOMA

Casady, Megan BS*; Faia, Lisa MD*,†; Nazemzadeh, Maryam MD*; Nussenblatt, Robert MD, MPH*; Chan, Chi-Chao MD*; Sen, H. Nida MD, MHS*

doi: 10.1097/IAE.0b013e31829977fa
Original Study

Purpose: To evaluate fundus autofluorescence (FAF) patterns in patients with primary intraocular (vitreoretinal) lymphoma.

Methods: Records of all patients with primary intraocular lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were evaluated with respect to clinical disease status and the findings on fluorescein angiography and spectral-domain optical coherence tomography.

Results: There were 18 eyes (10 patients) with primary intraocular lymphoma that underwent FAF imaging. Abnormal autofluorescence in the form of granular hyperautofluorescence and hypoautofluorescence was seen in 11 eyes (61%), and blockage by mass lesion was seen in 2 eyes (11%). All eyes with granular pattern on FAF had active primary intraocular lymphoma at the time of imaging, but there were 5 eyes with unremarkable FAF, which were found to have active lymphoma. The most common pattern on fluorescein angiography was hypofluorescent round spots with a “leopard spot” appearance (43%). These hypofluorescent spots on fluorescein angiography correlated with hyperautofluorescent spots on FAF in 5 eyes (36%) (inversion of FAF). Nodular hyperreflective spots at the level of retinal pigment epithelium on optical coherence tomography were noted in 43% of eyes. The hyperautofluorescent spots on FAF correlated with nodular hyperreflective spots on optical coherence tomography in 6 eyes (43%).

Conclusion: Granularity on FAF was associated with active lymphoma in majority of the cases. An inversion of FAF (hyperautofluorescent spots on FAF corresponding to hypofluorescent spots on fluorescein angiography) was observed in less than half of the eyes.

This retrospective study evaluating fundus autofluorescence imaging in patients with primary intraocular (vitreoretinal) lymphoma showed that abnormal autofluorescence in the form of granular hyperautofluorescence and hypoautofluorescence was seen in the majority of eyes. All eyes with granular pattern on fundus autofluorescence had active primary intraocular (vitreoretinal) lymphoma; however, all eyes with active disease did not demonstrate fundus autofluorescence abnormality. The hyperautofluorescent spots on fundus autofluorescence correlated with the hypofluorescent spots on fluorescein angiography and the nodular hyperreflective spots on optical coherence tomography in approximately one third of cases.

*National Eye Institute, National Institutes of Health, Bethesda, Maryland; and

Associated Retinal Consultants, P.C., Royal Oak, Michigan.

Reprint requests: H. Nida Sen, MD, MHS, National Eye Institute, National Institutes of Health, 10 Center Drive, 10/10N109, Bethesda, MD 20892; e-mail: senh@nei.nih.gov

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.