Retromode imaging in vitreoretinal lymphoma

Purpose: The purpose of this study was to evaluate Retromode (Nidek Co., Gamagori, Japan) as an adjunct diagnostic tool in vitreoretinal lymphoma (VRL). By integrating Retromode findings with multimodal imaging, we aimed to enhance lesion detection of VRL lesions in the retina. Methods: This monocentric retrospective pilot study was conducted at the Ocular Oncology unit of San Raffaele Scientific Institute, Milan. Six consecutive patients with biopsy-proven vitreoretinal lymphoma (VRL) were analyzed. Comprehensive retinal examinations and multimodal imaging, encompassing Retromode, pseudocolor fundus photography, fundus autofluorescence (FAF), and optical coherence tomography (OCT). The study specifically focused on the role of Retromode findings used in conjunction with traditional imaging modalities like FAF and OCT to enhance lesion detection associated with VRL. Imaging analysis was conducted using ImageJ software. Results: Retromode identified detailed structural abnormalities in the deep retinal layers and RPE, revealing additional or more widespread lesions compared to FAF imaging. Retromode pinpointed areas affected by VRL for further examination with OCT. However, in patients with vitritis—a common condition in VRL—Retromode did not yield quality images or meaningful information. Conclusion: Retromode imaging proved to be a valuable adjunct in the multimodal imaging approach to VRL. Its capacity to delineate subtle retinal changes facilitates a tailored diagnostic strategy, enhancing lesion detection and characterization in VRL.