Authors: Wai-Ching Lam, Nick Fung, Qing Li, Ian Wong

Author Disclosure Block: W. Lam: None. N. Fung: None. Q. Li: None. I. Wong: None.

Abstract Body:

Purpose: Intraocular lymphoma represents a diverse group of hematologic malignant neoplasm involving different tissues with the eye. Often the pathological changes are limited in the ocular tissue without systemic manifestation. It is difficult to monitor the disease progression and treatment response when there is no systemic manifestation of the disease.
Study Design: Retrospective case series.
Methods: Three patients diagnosed with relapsing intraocular lymphoma was treated with intravitreal methrotrexate(MTX) from Jan 2016 to Dec 2017 were reviewed for diagnosis, visual acuity, treatment regimen, treatment response and side effects, biweekly OCT and FAF features before and after treatment.
Results: In all 3 patients, Spectral Domain-OCT showed initially increased hyper-reflective lesions in the sub-RPE area with disease progression. Other findings include rim of subretinal fluid, disruption of junction of inner segment/outer segment and rippling of retinal pigment epithelium. The fundus autofluorescence(FAF) also showed granular hyper-fluorescene pattern. After the patients were treated with intravitreal MTX, many of the OCT features and FAF resolved.
Conclusions: In intraocular lymphoma, lymphoma cells typically infiltrate between the RPE and Bruch’s membrane. OCT and FAF features are useful in diagnosis and assessment of treatment response of patient with intraocular lymphoma receiving intravitreal MTX.