Fig 1.
Fundus photo and optical coherence tomography (OCT) scans of a 54-year-old male patient diagnosed with vitreoretinal lymphoma in his left eye.
(A) A fundus photo in the active phase (before methotrexate treatment) shows multiple whitish lesions on the macula, and this appears as subretinal infiltration on OCT (arrow). OCT shows obliteration of the sub-retinal pigment epithelium (RPE) and outer retinal hyper-reflective layer. Aqueous cytokine level analysis shows elevation in interleukin (IL)-10 (1720.0 pg/mL) and in the IL-10-to-IL-6 ratio (1720). (B) In the remission phase, the fundus photo shows loss of the whitish lesions, and OCT shows the absence of infiltration with the recovery of the RPE and outer-retinal layer. The sub-foveal choroidal thickness and choroidal area are decreased compared to that in the active phase. The IL-10 level (27.8 pg/mL) and IL-10-to-IL-6 ratio (5.35) have also decreased.
Table 1.
Demographic and clinical characteristics of the participants.
Table 2.
Comparison of clinical parameters at baseline (pre-treatment) and the point of clinical resolution after intravitreal methotrexate injection.
Fig 2.
Comparison of choroidal measurements in vitreoretinal lymphoma (VRL) eyes and their fellow eyes.
Subfoveal choroidal thickness (SFCT) is shown in μm, and the total choroidal area (TCA), choroidal stromal area (SA), and choroidal luminal area (LA) are shown in mm2. Data are expressed as the mean ± standard deviation. (A) In VRL eyes, the mean SFCT was 290.8±93.5 in the active phase and 244.4±86.2 in remission (p<0.001). Mean SFCT after maintenance treatment was 255.50±80.61, which was not significantly different from that in remission (p = 0.690). In the fellow eyes, the mean SFCT was 241.3±100.9 in the active phase and 244.4±103.1 in remission (p = 0.204). (B) In VRL eyes, the mean TCA was 1.30±1.79 in the active phase and 0.69±0.23 in remission (p = 0.001). Mean TCA after maintenance treatment was 0.81±0.31, which was not significantly different from that in remission (p = 0.051). In the fellow eyes, the mean TCA was 0.94±0.37 in the active phase and 0.92±0.36 in remission (p = 0.128). (C) In VRL eyes, the mean SA was 0.32±0.08 in the active phase and 0.26±0.06 in remission (p = 0.025). Mean SA after maintenance treatment was 0.29±0.07, showing a slight increase compared to that in remission (p = 0.027). In the fellow eyes, the mean SA was 0.34±0.12 in the active phase and 0.35±0.13 in remission (p = 0.091). (D) In VRL eyes, the mean LA was 0.98±1.80 in the active phase and 0.45±0.22 in the remission phase (p = 0.004). Mean LA after maintenance treatment was 0.51±0.24, which did not differ significantly from that in remission (p = 0.380). The post-treatment decrease in the choroidal area in VRL patients was more prominent for LA compared to SA, but there was no significant difference in the choroidal vascular index. In the fellow eyes, the mean LA was 0.60±0.25 in the active phase and 0.57±0.23 in remission (p = 0.611).
Table 3.
Correlation between the number of injections required for clinical resolution and other clinical values.