Longitudinal observation of OCT imaging is a valuable tool to monitor primary vitreoretinal lymphoma treated with intravitreal injections of methotrexate
Longitudinal observation of OCT imaging is a valuable tool to monitor primary vitreoretinal lymphoma treated with intravitreal injections of methotrexate
复制标题
DOI：
10.1186/s12886-019-1300-1
复制
发表时间：
2020-01-06
影响因子：
2
通讯作者：
Peng, Xiaoyan
中科院分区：
文献类型：
--
作者：
Zhao, Huiying;Wang, Xiaona;Peng, Xiaoyan
背景发展客观和可重复的指标来评估PVRL治疗的疗效是重要的。玻璃体细胞的定量是一个传统的标准；然而，微小的变化很难确定。光谱域光学相干层析成像(SD-OCT)是一种客观的、可重复的、易于解释的方法。本研究的目的是对玻璃体内注射甲氨蝶呤(MTX)治疗的PVRL患者进行OCT的纵向观察，评价OCT在监测PVRL对治疗反应中的作用。方法收集2016年1月至2017年9月在本院接受MTX玻璃体注射的PVRL患者的临床资料。两位研究者分别对治疗前后的OCT图像进行回顾。结果在24例患者中，包括10例患者(18只眼)。首次就诊的SD-OCT异常包括玻璃体细胞(18/18)、视网膜外边界模糊(12/18)、色素上皮脱离(9/18)、视网膜下高反射性浸润性病变(3/18)、视网膜内浸润性病变(8/18)、视网膜下积液(4/18)。诱导治疗后视网膜脱离患者SRF吸收，视网膜下纤维化。其他病变明显减少。巩固治疗后边界模糊，PED、SRF消失2眼，视网膜内浸润消失1眼，其他异常进一步改善。此外，3只眼观察到视网膜纤维化。维持治疗一个月后，首次就诊时观察到的所有异常都消失了。最后一次检查时，OCT表现为视网膜下纤维化，3只眼(16.7%)，9只眼(50%)外视网膜破裂，4只眼(22.2%)全层变薄。结论PVRL患者的OCT特征可随着治疗逐渐减少，最终消失。我们建议，SD-OCT可用于监测PVRL对治疗的反应性，这可能会影响本病的治疗决策。
BackgroundDeveloping objective and repeatable indicators to evaluate the efficacy of PVRL treatment is important. The quantification of vitreous cells is a traditional criterion; however slight changes are difficult to ascertain. Spectral domain optical coherence tomography (SD-OCT) is objective, repeatable, and easily explained. The purpose of this study is to provide a longitudinal observation of OCT in PVRL treated with intravitreal injections of methotrexate (MTX) and to evaluate the utility of OCT in monitoring responsiveness of PVRL to treatment.MethodsThe medical records of patients with biopsy-positive PVRL attending our hospital between January 2016 and September 2017 who received intravitreal injections of MTX were included in this study. Pre- and post-treatment OCT images were reviewed independently by two researchers.ResultsOf the 24 cases reviewed, 10 patients (18 eyes) were included. SD-OCT abnormalities at the initial visit included vitreous cells (18/18), OR (outer retina) fuzzy borders (12/18), PED (pigment epithelium detachments) (9/18), subretinal hyperreflective infiltration (3/18), intraretinal infiltration (8/18), and SRF (subretinal fluid) (4/18). Post induction treatment, SRF in cases with RD (retinal detachment) was absorbed, and subretinal fibrosis appeared. Other lesions were significantly reduced. Post consolidation treatment, OR fuzzy borders, PED and SRF disappeared in 2 eyes, intraretinal infiltration disappeared in 1 eye, and other abnormalities further improved. Additionally, retinal fibrosis was observed in 3 eyes. One month post maintenance treatment, all abnormalities observed at the first visit vanished. At the last visit, OCT showed subretinal fibrosis and in 3 eyes (16.7%), the disruption of outer retina in 9 eyes (50%) and thinning of the whole layer in 4 eyes (22.2%).ConclusionsOur observations reveal that characteristic OCT features in PVRL patients can reduce gradually and finally vanish with therapy. We propose that SD-OCT may be employed to monitor the responsiveness of PVRL to treatment, which may influence decision making in the management of this disease.