In Vivo Confocal Microscopy of Keratic Precipitates in Vitreoretinal Lymphoma

Ocul Immunol Inflamm. 2024 Aug;32(6):919-924. doi: 10.1080/09273948.2022.2151020. Epub 2022 Dec 12.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intraocular Lymphoma / diagnosis
  • Intraocular Lymphoma / pathology
  • Male
  • Microscopy, Confocal*
  • Middle Aged
  • Retinal Neoplasms* / diagnosis
  • Retinal Neoplasms* / pathology
  • Retrospective Studies
  • Vitreous Body* / diagnostic imaging
  • Vitreous Body* / pathology