Vertical Hyperreflective Lesions on Optical Coherence Tomography in Vitreoretinal Lymphoma

Abstract

Importance Vitreoretinal lymphoma is a diagnostic challenge and the pathophysiology is still unclear. Objective To describe an imaging finding seen on optical coherence tomography (OCT) of patients with vitreoretinal lymphoma. Design, Setting, and Participants This case series study was a retrospective medical record review of patients who received a diagnosis of vitreoretinal lymphoma at the Department of Ophthalmology at Northwestern University between July 2014 and January 2016. Main Outcomes and Measures Optical coherence tomography findings in vitreoretinal lymphoma. Results We identified 7 patients (4 women [57.1%]; mean [range] age, 62.4 [45-75] years; 12 eyes) with intraocular lymphoma involving the retina (5 patients [71.4%] with primary vitreoretinal or central nervous system lymphoma with ocular involvement, 1 patient [14.3%] with testicular lymphoma with secondary central nervous system lymphoma and vitreoretinal lymphoma, and 1 patient [14.3%] with secondary vitreoretinal lymphoma). We identified vertical hyperreflective lesions that showed moderate or high reflectivity and affected all layers of the neuroretina in 5 patients (7 of 12 eyes [58.3%]). These often preceded the development of subretinal pigment epithelial deposits and were often localized around second-order and third-order retinal vessels. In most cases, they resolved with minimal or no scarring after the initiation of chemotherapy. Conclusions and Relevance Vertical hyperreflective lesions are a common physical finding on OCT in eyes with vitreoretinal lymphoma.