Bilateral Severe Vitritis, an intraocular recurrence of B cell lymphoma: A case report.
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Resumen
Purpose: To report a case of bilateral vitritis originated from Primary Central Nervous System Lymphoma. Diagnosis was made from a careful history taking and confirmed with vitrectomy. Case report: 65-year-old Vietnamese male had one month of progressive blurred vision in both eyes without other eye complaint. History revealed that about one year previously, he was diagnosed with primary diffuse large B cell lymphoma. He was treated with chemotherapy of Methotrexate 3.5 g/m2 and cytarabine 2 mg/m2, and a whole brain radiation therapy. There was a complete remission after the therapy. Fundus of both eyes was partly obscured by cells mainly in the posterior vitreous. Sequential bilateral vitrectomies were done on 5/1/17 and 7/17/17 without complication. The vitreous sample from the first eye having vitrectomy was sent for study which demonstrated large B cell lymphoma. Post-operative vision improved to 20/25 both eye without the complaint of hazy vision. Conclusion: Good history taking assisted in the diagnosis of intraocular lymphoma in this case with bilateral vitritis. However, bilateral vitrectomy restored the vision and further confirmed the diagnosis of lymphoma for future follow up care.
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Chan, C.C., & Wallace, D.J. Intraocular lymphoma: update on diagnosis and management. Cancer Control., 11:285–95, 2004.
DeAngelis, L.M., Seiferheld, W., Schold, S.C., Fisher, B., & Schultz, C.J. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology GroupStudy 93-10. J Clin Oncol.,208(24):4643–8, 2002.
Frenkel, S., Hendler, K., Siegal, T., Shalom, E., & Pe’er, J. Intravitreal methotrexate for treating vitreoretinal lymphoma: 10 years of experience. Br J Ophthalmol., 92:383–8, 2008.
Hormigo, A., & DeAngelis, L.M. Primary ocular lymphoma: clinical features, diagnosis and treatment. Clin Lymphoma.,4:22–9, 2003.
Hochberg, F.H., & Miller, D.C. Primary central nervous system lymphomas. J Neurosurg., 68:835– 53, 1988.
Helbig, H., Cerny, T., & de Smet, M.D. Intravitreal chemotherapy for intraocular lymphoma. Ophthalmologe., 100:145–9, 2003.
Panageas, K.S., Elkin, E.B., DeAngelis, L.M., BenPorat, L., & Abrey, L.E. Trends in survival from primary central nervous system lymphoma, 1975-1999: a population-based analysis. Cancer., 104(11):2466–72,2005.
Smith, J.R., Rosenbaum, J.T., Wilson, D.J., Doolittle, N.D., Siegal, T., Neuwelt, E.A., & Pe’er, J. Role of intravitreal methotrexate in the management of primary central nervous system lymphoma with ocular involvement. Ophthalmology.,109:1709–16,2002.
Wilson, D.J., Braziel, R., & Rosenbaum, J.T. Intraocular lymphoma: immunopathologic. Analysis of vitreous biopsy specimens. Arch Ophthalmol.,110:1455–8, 1992.
Zamiri, P., Boyd, S., & Lightman, S. Uveitis in the elderly-Is it easy to identify the masquerade? British J Ophthalmol., 81:827–31, 1997