Abstract
Purpose :
To assess the clinical course of patients and decision for vitreous biopsy, with history of lymphoma, who present with intraocular inflammation.
Methods :
Retrospective chart review of patients who were diagnosed with vitreoretinal lymphoma who also have a history of lymphoma from a non-ocular site. Patients without a prior or concurrent diagnosis of non-ocular lymphoma, but who had eventual diagnosis of vitreoretinal lymphoma, were also assessed for comparison in terms of timeline from symptoms to vitreous biopsy.
Results :
A small subset of patients have been identified between 2017 and 2022 at the University of Massachusetts Medical School who presented to Ophthalmology Clinic with uveitis in one or both eyes. All patients underwent vitrectomy with vitreous biopsy samples that came back positive for a diagnosis of intraocular lymphoma. One patient with a history of lymphoplasmacytic lymphoma was found to have a rare presentation of intraocular Richter's transformation, which has only been described a handful of times in the literature since 1928. Another patient with a history of testicular lymphoma was diagnosed initially with retinitis but vitreous biopsy results showed diffuse large B cell lymphoma. In comparison to patients without a prior history of lymphoma, the time to obtain vitreous biopsy from initial clinic presentation was decreased.
Conclusions :
The decision to perform vitrectomy for definitive diagnosis in patients presenting with persistent panuveitis, who have a known history of lymphoma from a non-ocular site, can be expedited. In these particular instances, it is prudent to rule out malignancy, as atypical presentations of lymphoma can become evident.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.