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DIAGNOSTIC TESTING AND TREATMENT CHOICES IN PRIMARY VITREORETINAL LYMPHOMA

Rajagopal, Rithwick MD, PhD*†; Harbour, J William MD*†

doi: 10.1097/IAE.0b013e31820a6743
Review Article
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Background: Primary vitreoretinal lymphoma is a rare intraocular malignancy often seen in the context of central nervous system lymphoma. This review updates the current approaches to the management of primary vitreoretinal lymphoma.

Methods: A review of current literature on the management of primary vitreoretinal lymphoma with an emphasis on contemporary diagnostic and treatment methods.

Results: Techniques for diagnosing primary vitreoretinal lymphoma from ocular biopsy specimens include cytologic analysis, immunocytochemistry, flow cytometry, polymerase chain reaction to detect V-J immunoglobulin gene rearrangements, and analysis of IL-6 and IL-10 in aqueous or vitreous fluid. Treatment options include external beam radiotherapy, systemic chemotherapy, and intravitreal chemotherapy.

Conclusion: Cytologic examination of intraocular biopsy specimens remains the gold standard for the diagnosis of PVRL, but ancillary tests can be very helpful in selected patients. Successful primary treatment of the eyes can be accomplished with external beam radiotherapy or intravitreal chemotherapy. Management decisions should be individualized on patient factors, local expertise, and patient preferences. Improvements in molecular diagnostics and local drug delivery are needed to improve the management of PVRL.

Cytologic examination of intraocular biopsy specimens remains the gold standard for the diagnosis of PVRL, but ancillary tests can be very helpful in selected patients. Successful primary treatment of the eyes can be accomplished with external beam radiotherapy or intravitreal chemotherapy. Management decisions should be individualized on patient factors, local expertise, and patient preferences. Improvements in molecular diagnostics and local drug delivery are needed to improve the management of PVRL.

From the *Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri; and †Barnes Retina Institute, St Louis, Missouri.

The authors have no conflicts of interest to disclose.

Reprint requests: J. William Harbour, MD, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8096, Saint Louis, MO 63110; e-mail: harbour@wustl.edu

© The Ophthalmic Communications Society, Inc.