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Raja, Harish MD; Salomão, Diva R. MD; Viswanatha, David S. MD; Pulido, Jose S. MD, MS, MPH, MBA

doi: 10.1097/IAE.0000000000000996
Original Study

Purpose: Myeloid differentiation primary response gene 88 (MYD88) is a universal adaptor protein in the innate immune system. When associated with a proline for leucine substitution mutation at position 265 (L265P), the protein becomes constitutively activated, amplifying the intracellular pro-inflammatory signal. Recently, we reported two cases of vitreoretinal lymphoma (VRL) that were positive for the mutation. The purpose of this study was to determine prevalence of the MYD88 L265P mutation in a larger series of VRL.

Methods: Retrospective chart review of 25 patients with histologically confirmed VRL evaluated at Mayo Clinic, Rochester, between January 2000 and March 2015. Paraffin-embedded blocks from the vitreous were submitted for polymerase chain reaction testing of the L265P mutation.

Results: The mutation was positive in 82.4% of all VRL cases and 86.7% of primary VRL cases. The minimum necessary DNA concentration needed for the polymerase chain reaction assay was 4.93 ng/mL.

Conclusion: MYD88 gene analysis is a helpful ancillary tool for diagnosing VRL. It often requires fewer cells than flow cytometry or cytology and may be especially useful in early cases where a sufficient number of cells may not be available.

Cases of vitreoretinal lymphoma have recently been reported to harbor the MYD88 L265P mutation. The authors report prevalence of this mutation in a series of vitreoretinal lymphoma cases evaluated at Mayo Clinic, Rochester, MN.

Departments of *Ophthalmology,

Anatomic Pathology, and

Hematopathology, Mayo Clinic, Rochester, Minnesota.

Reprint requests: Jose S. Pulido, MD, MS, MPH, MBA, Department of Ophthalmology and Department of Molecular Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905; e-mail:

Supported by Research to Prevent Blindness, New York, NY, and also by a grant from VRS Foundation, Minneapolis, MN.

Paper presented at Maculart, Paris, France, June 28, 2015.

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

© 2016 by Ophthalmic Communications Society, Inc.