The Role of Chorioretinal Biopsy in the Diagnosis of Intraocular Lymphoma.
OBJECTIVE
To assess the clinical usefulness of chorioretinal biopsy in establishing a definitive diagnosis in intraocular lymphomas.


METHODS
Retrospective, noncomparative, consecutive diagnostic case series.


METHODS
setting: Moorfields Eye Hospital, London, United Kingdom.


METHODS
Twenty-nine consecutive patients presenting with severe uveitis that required an intraocular biopsy where underlying lymphoma was suspected.


METHODS
A retrospective review of a 15-year period (1999-2014) was undertaken of all patients that have undergone chorioretinal biopsy for suspected lymphoma at Moorfields Eye Hospital, London, United Kingdom. Patients were identified on the hospital's computerized database.


METHODS
Effectiveness of chorioretinal biopsy in establishing a definitive diagnosis or in excluding malignancy.


RESULTS
A specific histologic diagnosis was made in 17 cases (59%) while in 9 cases the biopsy combined with clinical data was effective in excluding malignancy. In the 3 remaining cases, no specific diagnosis was made. No intraoperative complications were reported. Postoperative complications other than cataract included 2 vitreous hemorrhages and 2 retinal detachments. Of the 17 cases with a histologic diagnosis, 15 were obtained in eyes with marked vitritis, as opposed to 2 with minimal vitritis.


CONCLUSIONS
Chorioretinal biopsy provided a definitive diagnosis of lymphoma in 59% of cases and assisted in exclusion of a further 31% in this series. The level of vitritis appears to act as a strong index of likelihood in achieving a definitive histologic diagnosis.
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Department of Neurological and Movement Sciences, University of Verona, Verona, Italy. Electronic address: rodolfo.mastropasqua@gmail.com.
Rodolfo
R
Mastropasqua
Institute of Ophthalmology, University College London, London, United Kingdom.
Caroline
C
Thaung
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom; National Institute for Health Research, Moorfields Biomedical Research Centre, London, United Kingdom.
Carlos
C
Pavesio
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom.
Susan
S
Lightman
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom.
Mark
M
Westcott
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom; National Institute for Health Research, Moorfields Biomedical Research Centre, London, United Kingdom.
Narciss
N
Okhravi
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
William
W
Aylward
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom; National Institute for Health Research, Moorfields Biomedical Research Centre, London, United Kingdom.
David
D
Charteris
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom; National Institute for Health Research, Moorfields Biomedical Research Centre, London, United Kingdom.
Lyndon
L
da Cruz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D002829:Choroid / Q000473:pathology*; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy; D055815:Young Adult