Table 2.
Clinical and laboratory features of patients who underwent 25-gauge diagnostic TSV
| Patient no./age/sex | Medical co-morbidities | Preoperative findings | Preoperative VA | Final VA | Total F/U (weeks) | AFX | Post-operative findings/complications | Vitreous testing for T- or B-cell IOL | MRI brain | Lumbar puncture | Final Dx |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1/64/M | Systemic B-cell lymphoma | Vitritis, RPE change | 20/20 | 20/40 | 54 | No | Cataract | CYTO, FC§, CYK§, IGH§ | Normal | No cytological evidence of lymphoma | B-cell IOL |
| 2/24/M | HTLV-1, CNS ATL | Vitritis, retinal vasculitis | 20/80 | 20/63 | 50 | No | Transient hypotony | CYTO, FC | Normal | – | HTLV-associated IU |
| 3/54/F | HTLV-1, CNS ATL | Vitritis, retinal vasculitis | 20/125 | 20/25 | 38 | No | None | CYTO§, FC§, TCR§, CYK§ | Normal | T-cell leukaemia/lymphoma | T-cell IOL |
| 4/65/F | Systemic T-cell lymphoma | Vitritis | 20/25 | 20/25 | 19 | No | Transient hypotony | CYTO, IHC, FC, TCR, CYK | Normal | No cytological evidence of lymphoma | Idiopathic IU |
| 5/72/F | Healthy | Vitritis, RPE changes | 20/40 | 20/20 | 36 | No | Cataract | CYTO, IHC, FC§, CYK, IGH | Small vessel ischaemic changes | No cytological evidence of lymphoma | Idiopathic IU* |
| 6/27/F | HIV, tuberculosis | Vitritis | 20/40 | 20/20 | 43 | No | Transient hypotony | CYTO, FC, CYK | Right frontal lobe lesion | No cytological evidence of lymphoma | Tuberculosis-associated IU |
| 7/79/F | CLL | Vitritis, Prior CRVO | HM | CF | 44 | No | Transient hypotony | CYTO, FC, IGH§ | Small vessel ischaemic changes | – | B-cell IOL |
| 8/70/F | HTLV-1, ATL | Vitritis, retinal vasculitis | LP | CF | 10 | Yes | CMV retinitis, NVG | CYTO, FC§, TCR§ | Normal | – | T-cell IOL |
| 9/52/M | Intra-abdominal mass near right renal pelvis | Vitritis, RPE changes | 20/25 | 20/25 | 25 | No | None | CYTO§, FC, CYK§, IGH§ | Normal | No cytological evidence of lymphoma | B-cell IOL |
| 10/65/M | Left frontal lobe mass, unclear aetiology | Vitritis, RPE changes | 20/20 | 20/20 | 39 | Yes | None | CYTO, FC, κ | Left frontal lobe mass | – | Probable B-cell IOL† |
| 11/69/M | Liver transplant | Vitritis | 20/70 | 20/40 | 26 | Yes | None | CYTO, FC, κ | Normal | – | Probable B-cell IOL |
| 12/42/F | CNS lymphoma | Vitritis | 20/50 | 20/40 | 11 | Yes | None | CYTO§,, FC, κ | Left parietal lobe mass | – | B-cell IOL |
AFX, air–fluid exchange performed at conclusion of vitrectomy procedure; ATL, adult T-cell leukaemia/lymphoma; CF, counting fingers; CLL, chronic lymphocytic leukaemia; CMV, cytomegalovirus; CNS, central nervous system; CRVO, central retinal vein occlusion; CYK, cytokine evaluation (ie, interleukin (IL)-10, IL-6, IL-2); CYTO, cytopathology; Dx, diagnosis; FC, flow cytometry; F/U, follow-up; HM, hand motions; HTLV, human T-cell lymphotrophic virus; IGH, IgH gene rearrangement studies; IHC, immunohistochemistry; IOL, intraocular lymphoma; IU, intermediate uveitis; NVG, neovascular glaucoma; RPE, retinal pigment epithelium; TCR, T-cell receptor gene rearrangement studies; TSV, transconjunctival sutureless vitrectomy; VA, visual acuity; κ, κ light chain gene rearrangement studies.
Patient 5 showed a monoclonal B-cell population by flow cytometry; however cytopathological evaluation, cytokine testing and IgH rearrangement studies were consistent with an inflammatory process.
A diagnostic brain biopsy was offered to this patient, but the patient deferred further intervention.
Indicates positive test.