This paper presented a retrospective review of medical records of HIV negative immunocompetent patients diagnosed with vitreoretinal lymphoma between 1994 and 2012. The aim of the paper was to evaluate the type and number of diagnostic interventions required to confirm the presence of vitreoretinal (VR) lymphoma. Twenty-seven cases were included. Of the 27 cases, diagnosis using pars plana vitrectomy was made in 13 (48%), vitreous tap in two (7.5%) and anterior chamber tap in one (3.7 %), chorioretinal biopsy in two (7.5%), brain biopsy in five (18.5%) and cerebrospinal fluid cytology via lumbar puncture in four (14.8%). Ten patients (37%) had definitive results on the first procedure and 17 (63%) had at least one false negative. Vitrectomy was the most common procedure and patients required a mean of 2.1 procedures. The average time from onset of symptoms to confirmed histopathological diagnosis was 13.9 months. VR lymphoma, a common masquerade uveitic syndrome, is difficult to recognise and requires a high degree of clinical suspicion. Most patients were initially thought to have idiopathic uveitis and treated with systemic corticosteroids. Treatment with corticosteroids at the time of vitrectomy may further complicate the diagnosis by leading to lysis of the lymphoma cells and false negative results of the vitreous samples. In this study none of the patients were on corticosteroid therapy at the time of vitreous sampling.

Diagnostic procedures in vitreoretinal lymphoma.
Dalal M, Casady M, Moriarty E, et al.
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Nikolaos D Georgakarakos

Moorfields Eye Hospital, London, UK.

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