Latest diagnostic possibilities in unsolved uveitis, suspicious for malignancy

Vitreo Retinal Lymphomas (VRL) are rare malignancies that display a wide spectrum of clinical patterns. Almost all VRL are non-Hodgkin's lymphomas, B-cell sub-type. Since the clinical presentation of VRL might be confused with a non-responder eye inflammation, VRL are also known as ‘masquerade syndromes’. On the basis of the potential severity of such disease, vitreous biopsy might be indicated for all the cases which can be potential VRL. Since vitreous biopsy is not diagnostic in all cases, further techniques can provide further essential data. Immunohistochemistry can be used for identifying important Cluster of Differentiation (CD) such as CD45 for leukocytes, CD20, CD79a, PAX-5 for B-cells, CD45RO for T-cells, and CD68 for macrophages. Furthermore, clonality can be established by using antibodies targeting the kappa and lambda light chains. Polymerase chain reaction gene rearrangement studies can identify monoclonality of the heavy chain variable (V), diversity (D), and joining (J) immunoglobulin gene segments. Recently, measurement of Interleukin (IL)-6 and IL-10 in aqueous and/or vitreous fluid can lead to the correct diagnosis, even though an elevated IL-10/IL-6 ratio is not specific for VRL.