通过检查临床和多模态成像特征并与有症状的 VRL 进行比较，报告和表征与原发性中枢神经系统淋巴瘤 (PCNSL) 相关的无症状玻璃体视网膜淋巴瘤 (VRL) 的眼部特征。回顾性横断面研究。细胞学或分子学证实的 VRL 患者被包括在内。患者被分为三组：原发性 VRL (PVRL)、与 PCNSL 相关的有症状 VRL (PCNSL-S) 或与 PCNSL 相关的无症状 VRL (PCNSL-AS)。收集的数据包括人口统计、视觉症状、视力 (VA) 和成像特征。通过单向方差分析和多项线性回归分析对组间定量和分类变量进行横断面分析。该研究包括 56 名 VRL 患者的 104 只眼睛。 29 名患者 (52%) 被诊断为 PVRL，27 名患者 (48%) 被诊断为与 PCNSL 相关的 VRL。其中，17 人 (63%) 报告有视觉症状 (PCNSL-S)，而 10 人 (37%) 无症状 (PCNSL-AS)。 PCNSL-AS 患者的 VA 优于 PVRL 患者（0.11 vs. 0.76 LogMAR，p=0.04）和独特的临床特征，眼前节受累率较低（比值比 [OR]=0.02；95% 置信区间 [CI] 0.12 -0.84；p<0.01）和玻璃体炎（OR=0.32；95%CI 0.11-0.91；p=0.03）。与 PVRL（OR= 0.14；95%CI 0.02-1.11；p=0.06）和 PCNSL-S（OR：0.08；95%CI 0.01-0.69 p=0.05）相比，PCNSL-AS 病例中视网膜下浸润较少见，并且与较差的 VA 相关（估计值=0.55 LogMAR；95%CI 0.29-0.8；p<0.01）。本研究描述了与 PCNSL 相关的无症状 VRL 的独特临床和影像学特征，其特点是 VA 较好且眼部受累较轻。研究结果强调了多模态成像在促进 PCNSL 分期中早期检测 VRL 方面的关键作用。未来的 PCNSL 管理指南应考虑诊断无症状 VRL 患者的必要性。版权所有 © 2024。由 Elsevier Inc. 出版。

To report and characterize ocular features of asymptomatic vitreoretinal lymphoma (VRL) associated with primary central nervous system lymphoma (PCNSL), by examining clinical and multimodal imaging characteristics and comparing with symptomatic VRL.Retrospective cross-sectional study.Patients with cytologically or molecularly confirmed VRL were included. Patients were classified into three groups: primary VRL (PVRL), symptomatic VRL associated with PCNSL (PCNSL-S), or asymptomatic VRL associated with PCNSL (PCNSL-AS). Data encompassing demographics, visual symptoms, visual acuity (VA), and imaging characteristics were collected. Cross-sectional analyses of quantitative and categorical variables among groups were performed with one-way ANOVA and multinomial linear regression analyses.The study included 104 eyes from 56 patients with VRL. Twenty-nine patients (52%) were diagnosed with PVRL, and 27 patients (48%) were diagnosed with VRL associated with PCNSL. Among these, 17 (63%) reported visual symptoms (PCNSL-S), whereas 10 (37%) were asymptomatic (PCNSL-AS). PCNSL-AS patients exhibited better VA than PVRL patients (0.11 vs. 0.76 LogMAR, p=0.04) and distinct clinical features, with lower rates of anterior segment involvement (odds ratio [OR]=0.02; 95% confidence interval [CI] 0.12-0.84; p<0.01) and vitritis (OR= 0.32; 95%CI 0.11-0.91; p=0.03). Subretinal infiltration was less common in PCNSL-AS cases compared to PVRL (OR= 0.14; 95%CI 0.02-1.11; p=0.06) and PCNSL-S (OR: 0.08; 95%CI 0.01-0.69 p=0.05) and was associated with worse VA (estimate=0.55 LogMAR; 95%CI 0.29-0.8; p<0.01).This study describes distinctive clinical and imaging features of asymptomatic VRL associated with PCNSL, characterized by better VA and less severe ocular involvement. The findings highlight the pivotal role of multimodal imaging in facilitating early detection of VRL in the staging of PCNSL. Future guidelines for PCNSL management should consider the necessity of diagnosing patients with asymptomatic VRL.Copyright © 2024. Published by Elsevier Inc.