To characterize optical coherence tomography (OCT) features of vitreoretinal lymphoma (VRL) at baseline, identify features associated with visual prognosis to improve patient outcomes, and describe longitudinal OCT changes following intravitreal methotrexate (IVT-MTX) treatment.
Approach:
Key Findings:
Sub-RPE deposits were the most prevalent OCT feature (92.1%) in a study of 38 eyes from 25 patients.
Baseline BCVA and EZ disruption were associated with worse visual outcomes.
The LASSO model showed an AUC of 0.929 for predicting significant vision loss based on EZ disruption and EZ-RPE attenuation.
OCT features indicated that vitreous cells resolved rapidly, while sub-RPE and subretinal deposits regressed slowly.
Interpretation:
Sub-RPE deposits are the most prevalent OCT finding in VRL, indicating a need for focused monitoring. EZ disruption and EZ-RPE attenuation are associated with worse visual prognosis, highlighting the importance of early detection. Following IVT-MTX treatment, OCT reveals differential response patterns across lesion compartments, which could inform treatment strategies.
Limitations:
Single-center study may limit generalizability; future multi-center studies are needed.
Retrospective design may introduce selection bias; prospective studies could provide more robust data.
Conclusion:
Quantitative OCT assessment is a sensitive, noninvasive tool for treatment monitoring in VRL, emphasizing its potential role in improving patient management.
