Primary Vitreoretinal Lymphoma in HIV Infection



Steffen, Jonel, Coupland, Sarah E ORCID: 0000-0002-1464-2069 and Smith, Justine R
(2020) Primary Vitreoretinal Lymphoma in HIV Infection. Ocular Immunology and Inflammation, 29 (3). pp. 621-627.

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Abstract

<i>Purpose</i>: To describe the epidemiology, clinical characteristics, diagnosis and treatment of human immunodeficiency virus (HIV)-related primary vitreoretinal lymphoma (PVRL).<i>Methods</i>: Narrative literature review.<i>Results</i>: HIV-related PVRL occurs in persons who are relatively young and generally have very low CD4+ T-cell counts. Vitritis with subretinal or sub-retinal pigment epithelial infiltrates is typical. Vitreous cytology remains the gold standard for diagnosis, supplemented by flow cytometry and genetic analyses of tumor cells, and measurement of aqueous or vitreous interleukin-10 levels. Concurrent brain involvement also may establish the diagnosis. Treatment includes antiretroviral therapy (ART), systemic chemotherapy (usually methotrexate-based) and local ocular treatment (intravitreal methotrexate, intravitreal rituximab, external beam radiotherapy). Systemic chemotherapy is of uncertain value for PVRL without other central nervous system involvement. Prognosis is poor, but has improved significantly compared to the pre-ART era.<i>Conclusions</i>: Ophthalmologists should consider the diagnosis of PVRL in HIV-positive individuals who present with intermediate or posterior uveitis.

Item Type: Article
Uncontrolled Keywords: Vitreoretinal lymphoma, intraocular lymphoma, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), masquerade, primary central nervous system lymphoma, diagnostic vitrectomy
Depositing User: Symplectic Admin
Date Deposited: 24 Aug 2020 07:27
Last Modified: 18 Jan 2023 23:36
DOI: 10.1080/09273948.2020.1751856
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3098555