Diagnostic Accuracy and Complementary Value of Biomarkers for Primary Vitreoretinal Lymphoma: A Systematic Review and Meta-analysis.
Combining interleukin-10/interleukin-6 ratio with MYD88 testing detects vitreoretinal lymphoma with near-total accuracy
Diagnostic Accuracy and Complementary Value of Biomarkers for Primary Vitreoretinal Lymphoma: A Systematic Review and Meta-analysis.
To evaluate the individual and combined diagnostic performance of cytokine, molecular, and clonality biomarkers for primary vitreoretinal lymphoma (primary vitreoretinal lymphoma).
A total of 2411 patients from 41 studies with confirmed primary vitreoretinal lymphoma or benign ocular inflammatory diseases.
combining both tests correctly flagged eye lymphoma in nearly all confirmed cases
Of 41 included studies, most were rated at high or unclear risk of bias across Quality Assessment of Diagnostic Accuracy Studies 2 domains, predominantly in patient selection because of retrospective designs and nonconsecutive sampling, and in the index test domain because of post hoc threshold selection.
The interleukin (interleukin)-10 to interleukin-6 ratio (27 studies; 1370 patients; AUSROC, 0.98; sensitivity, 0.89; specificity, 0.98; I 2 = 61% and 69%, respectively; low certainty) showed no publication bias.
Parallel testing of interleukin-10 to interleukin-6 ratio and MYD88 seemed to offer the highest diagnostic performance among evaluated strategies for primary vitreoretinal lymphoma, although this finding requires prospective validation given the low to very low certainty of the underlying evidence.
Aqueous humor cytokine testing yielded higher diagnostic odds ratios than vitreous fluid, suggesting anterior paracentesis for interleukin-10 to interleukin-6 ratio before vitreous biopsy for molecular confirmation.