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A. Mashayekhi, C. L. Shields, M. Furuta, J. A. Shields; Posterior Uveal Lymphoid Neoplasia: A Review of 21 Cases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5942. doi: https://doi.org/.
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To describe the clinical features of posterior uveal lymphoid neoplasia (PULN).
Noncomparative series of 25 eyes of 21 patients managed at the Oncology Service, Wills Eye Institute.
The mean age of patients was 61 years (range, 44-80), 90% were Caucasian, and 81% were male. The most common symptoms were blurred vision (56%), red eye (12%), floaters (8%), and 24% were asymptomatic. The mean duration of symptoms before referral was 13 months (range, 1-60 months). 43% of patients were referred with the correct diagnosis of lymphoid infiltration. 4 (19%) of patients had bilateral ocular/periocular lymphoid infiltration. Conjunctival and iris lymphoid infiltration were present in 44% and 12% of eyes, respectively, and iritis/keratic precipitates were seen in 6 eyes (24%). All eyes had involvement of the macula whereas involvement of the foveola by the lymphoid infiltration was present in 64%. Appearance of choroidal infiltration on funduscopy was patchy in 14%, diffuse in 48%, and mixed in 38% of eyes. Other funduscopic findings included optic disc swelling (32%), retinal pigment epithelial clumps (28%), and choroidal folds (16%). 92% of eyes had detectable thickening of choroid on B-scan ultrasonography and the involved choroid was acoustically hollow in 95% of these eyes. Mean choroidal thickness was 2.5 mm (range, 1.0-4.2 mm). Posterior epibulbar extension was noted in 56% of eyes on B-scan ultrasonography. Optical coherence tomography was done in 16 eyes and showed subretinal fluid in 5 eyes (31%), retinal edema in 5 eyes (31%), and irregular RPE-choriocapillaris contour in 12 eyes (75%). Tissue biopsy diagnostic of lymphoid infiltration was obtained in 87% of patients. Four (19%) patients had systemic lymphoma.
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