In Vivo Confocal Microscopy of Keratic Precipitates in Vitreoretinal Lymphoma

ABSTRACT

Purpose

To investigate the morphological features of keratic precipitates (KPs) with in vivo confocal microscopy (IVCM) in vitreoretinal lymphoma (VRL).

Methods

Patients with biopsy-proven VRL were reviewed, and 12 patients (16 eyes) with KPs examined by IVCM were included.

Results

Five distinct KP morphologies on IVCM were observed: dendritic, nibbling, linear, globular, and stippled. Dendritic KPs were discovered in 9 eyes (56.3%), with a hyperreflective core and multiple thin pseudopodia. Nibbling KPs were found in 8 eyes (50.0%), featuring irregularly hyperreflective borders and a mottled reflective interior. Linear, stippled, and globular KPs were self-explanatory and affected nearly all eyes. Globular KPs seem to be formed by hyperreflective cells with large nuclei and prominent nucleoli, similar to atypical lymphocytes in vitreous cytology.

Conclusions

IVCM could provide more insight into the morphological traits of KPs than clinical observation, highlighting its potential for identifying VRL involving the anterior segment.

KEYWORDS:

• In vivo confocal microscopy
• keratic precipitates
• vitreoretinal lymphoma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Dr. XYP had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: XYP, WXG. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: WXG, YZ. Critical revision of the manuscript for important intellectual content: XYP, XZ. All authors read and approved the submission of this paper.

Ethics approval and consent to participate

This study was approved by the Ethic Committee of Beijing Tongren Hospital, and all patients provided written informed consent.

Data availability statement

All data generated or analyzed during this study are included in this published article.

Consent for publication

All personal information were removed, and no consent for publication was needed.

Additional information

Funding

This study was supported by the Key Research Program of the Beijing Institute of Ophthalmology (NO. 2019005).