Vitreoretinal lymphoma: a diagnostic challenge

Arch Soc Esp Oftalmol (Engl Ed). 2023 Dec;98(12):718-722. doi: 10.1016/j.oftale.2023.10.002. Epub 2023 Oct 7.

Abstract

A 66-year-old man with posterior uveitis and recurrent cystic macular edema related to possible previously treated Lyme disease is presented. Due to the recurrence of macular edema despite systemic and local corticosteroid treatment with intravitreal dexamethasone, biological treatment with Adalimumab was established. During follow-up, the patient developed bilateral subretinal lesions compatible with Vitreoretinal Lymphoma (VRL), so vitrectomy was performed, confirming the diagnosis of large B-cell lymphoma. Treatment with systemic chemotherapy with BRAM-Carmustine, Metrotexate, Ara C, and Rituximab was started with a good answer. Two years later, the patient remains without ocular or systemic recurrences. Vitreoretinal Lymphoma is a rare type of primary central nervous system lymphoma. The diagnosis is frequently delayed due to the nonspecific symptoms, which mimic chronic posterior uveitis, hence the importance with a diagnostic suspicion.

Keywords: Linfoma vitreorretiniano; Posterior uveitis; Uveítis posterior; Vitrectomy; Vitrectomía; Vitreoretinal lymphoma; Vitritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Eye Neoplasms* / diagnosis
  • Eye Neoplasms* / pathology
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse* / surgery
  • Macular Edema* / diagnosis
  • Macular Edema* / etiology
  • Male
  • Retinal Neoplasms* / pathology
  • Uveitis, Posterior*
  • Vitreous Body