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DIFFERENTIAL DIAGNOSIS FOR VITREORETINAL LYMPHOMA WITH VITREORETINAL FINDINGS, IMMUNOGLOBULIN CLONALITY TESTS, AND INTERLEUKIN LEVELS

Authors
 Lee, Junwon  ;  Kim, Seung WOO  ;  Kim, Hyesun  ;  Lee, Christopher SEUNGKYU  ;  Kim, Min  ;  Lee, Sung CHUL 
Citation
 Retina- the Journal of Retinal and Vitreous Diseases, Vol.39(6) : 1165-1176, 2019 
Journal Title
 Retina- the Journal of Retinal and Vitreous Diseases 
ISSN
 0275-004X 
Issue Date
2019
Abstract
PURPOSE: To analyze vitreoretinal findings, immunoglobulin clonality tests, and interleukin (IL) levels for diagnosing vitreoretinal lymphoma (VRL). METHODS: Forty-three patients who underwent diagnostic vitrectomy for suspected VRL were retrospectively reviewed. Of those patients finally diagnosed with VRL and nonlymphoma, ophthalmic evaluation and cytology results, IL-6 and IL-10 levels, and immunoglobulin heavy chain and immunoglobulin kappa light chain clonality assays were compared. RESULTS: Sub-retinal pigment epithelium infiltration and veil-pattern vitreous opacity were specific vitreoretinal findings in patients with VRL. The area under the receiver operating characteristic curve of the IL-10-to-IL-6 ratio and of IL-10 levels was 0.972 and 0.931, respectively. A combined immunoglobulin heavy chain and immunoglobulin kappa light chain assay showed increased sensitivity, whereas the determined specificity of immunoglobulin kappa light chain, at 94.12%, was much higher than the 78.95% of immunoglobulin heavy chain. Patients with VRL with atypically elevated IL-6 levels showed extensive and severe sub-retinal pigment epithelium infiltration. CONCLUSION: Newly screened immunoglobulin kappa light chain clonality assays may be useful to distinguish VRL from uveitis with high specificity. When sub-retinal pigment epithelium or retinal infiltration is severe and extensive, the IL-10-to-IL-6 ratio may not be typical and should be carefully interpreted.
Full Text
https://oce.ovid.com/article/00006982-201906000-00019/HTML
DOI
10.1097/IAE.0000000000002127
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Kim, Seung Woo(김승우) ORCID logo https://orcid.org/0000-0002-5621-0811
Lee, Sung Chul(이성철) ORCID logo https://orcid.org/0000-0001-9438-2385
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
Lee, Jun Won(이준원) ORCID logo https://orcid.org/0000-0003-0543-7132
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170925
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