Original Article Intraocular Lymphoma - Lessons learnt by an ophthalmologist

Intraocular Lymphoma - Lessons learnt by an ophthalmologist

Abstract

Introduction: PIOL can have various presentations; most commonly, it masquerades as an intermediate and/or posterior uveitis. It usually originates from vitreoretina, known as primary vitreoretinal lymphoma (PVRL) or from uveal tissue and the optic nerve. This gives the ophthalmologist an avenue to use the eye as a window to the brain or the body and suspect / diagnose disease prior to its spread. 

Methods: Retrospective chart review of patients with PVRL; from January 2014 to December 2019.

Results: In the study period; 4 patients (2 females / 2 males) had PVRL. Two patients (both females) were 50 years; one was 53 and one was 65 years. Initial diagnoses were “tubercular sub-retinal abscess”, “VKH Disease”, “viral uveitis” & “Optic neuritis”. With a high index of suspicion for PVRL based on clinical picture and inadequate response; an initial cytological analysis of the vitreous was done in 3 patients and was normal. CNS involvement occurred in all patients; in10, 5, 35 and 9 months after initial vitreoretinal involvement. Histopathological diagnosis made in all patients after a brain biopsy leading to chemotherapy.

Conclusion: PVRL is increasingly presenting in younger age group and should be kept in mind in patients with atypical uveitis. The eye indeed is a window to the brain or the body for an ophthalmologist to suspect / diagnose intraocular lymphoma; a disorder masquerading as intraocular inflammation; prior to its CNS spread.