Purpose: This study aimed to investigate the effectiveness of intravitreal cytokine measurement and cytology when diagnosing primary intraocular lymphoma (PIOL).
Subjects and methods: Of the cases with ocular findings consistent with PIOL that were examined at the Department of Ophthalmology of Japan Community Health Care Organization Osaka Hospital between December 2010 and March 2017, the subjects comprised 18 eyes diagnosed with PIOL based on the onset of intracerebral lesions and disappearance of the intracerebral focus following systemic chemotherapy. Using an intravitreal cytokine ratio of IL-10/IL-6>1 together with determination of ClassIV or greater on cytology considered to indicate positivity, the biopsy positivity rate was investigated. Next, we investigated whether clinical features or performing steroid treatment prior to biopsy affected biopsy results. We also examined whether IL-10 measured values could be used as an index for auxiliary diagnosis.
Results: The positive rates of cytokine analysis and cytological examination were 55.6% and 33.3%, respectively. Meanwhile, the number of negative cases detected by cytokine ratio and cytology were 22% each. The cases indicated to be positive by either cytokine ratio or cytology accounted for 7 of the 7 eyes that had not undergone steroid treatment and 7 of the 11 eyes that had undergone steroid treatment. Thus, although no significant difference was observed, the positivity rate was higher in the group that had not undergone steroid treatment. In 66.7% of cases, the actual measured IL-10 was ≥ 50 pg/mL.
Conclusions: A diagnosis could be made based on cytokine ratio and cytology in approximately 80% of cases. However, approximately 20% of PIOL cases were unable to be diagnosed based on cytokine ratio and cytology alone.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 559-564, 2018.