More Accurate Diagnosis of Vitreoretinal Lymphoma Using a Combination of Diagnostic Test Results: A Prospective Observational Study

ABSTRACT

Purpose

To establish diagnostic criteria for vitreoretinal lymphoma (VRL) using cytology and laboratory tests from vitreous samples: interleukin (IL)-10/IL-6 ratio, immunoglobulin (Ig) H gene rearrangement, and clonal B-cells on flow cytometry.

Methods

Fifty-six patients with and 39 without VRL were included. We assessed the sensitivity and specificity of each test and those of diagnostic criteria based on combinations of these tests.

Results

The sensitivity values for malignant cytology, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry were 0.554, 0.821, 0.732, and 0.625 with specificity of 1.000, 1.000, 0.846, and 0.974, respectively. When the diagnostic criteria were set at malignant cytology or at two or more of of four tests (atypical cells, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry), the sensitivity and specificity values for accurate diagnosis were 0.929 and 1.00, respectively.

Conclusion

Malignant cytology or positive results for two or more of four tests may be adequate for VRL diagnosis.

KEYWORDS:

• Intraocular lymphoma
• vitreoretinal lymphoma
• interleukin-10
• IgH gene rearrangement
• flow cytometry

Acknowledgments

The manuscript was edited for English grammar by a native writer at Editage.

Declaration of interests

The authors report no conflicts of interests. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by Japan Society for the Promotion of Science [16K11281,19K09986].