Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration
Purpose: To report the findings supported by multimodal imaging in a case of secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration. Observations: A 64-year-old man with systemic diffuse large B-cell lymphoma presented with reduced visual acuity. Moderate ant...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624000501 |
| _version_ | 1797257694388682752 |
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| author | Emily S. Levine Nikhil N. Batra |
| author_facet | Emily S. Levine Nikhil N. Batra |
| author_sort | Emily S. Levine |
| collection | DOAJ |
| description | Purpose: To report the findings supported by multimodal imaging in a case of secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration. Observations: A 64-year-old man with systemic diffuse large B-cell lymphoma presented with reduced visual acuity. Moderate anterior chamber and vitreous cell were present. Fundus exam showed bilateral disc edema and diffuse opaque macular infiltrates with a pseudo cherry-red spot in the left eye. Optical coherence tomography showed inner retinal infiltration and loss of normal architecture. Surgery for tissue biopsy was discussed and declined due to risk. Instead, multimodal imaging and anterior chamber fluid sampling were used as a surrogate for tissue biopsy and helped rule out infectious uveitis and retinal vascular disease. The patient was empirically treated with intravitreal methotrexate with rapid improvement in vision, exam, and quality of life. Conclusions and importance: Multimodal imaging can support a presumed diagnosis of secondary vitreoretinal lymphoma in order to proceed with intravitreal methotrexate treatment, which can result in rapid clinical and visual improvement. |
| first_indexed | 2024-04-24T22:41:43Z |
| format | Article |
| id | doaj.art-92e95a3281dd471b93922ceff64dc9e1 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-04-24T22:41:43Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-92e95a3281dd471b93922ceff64dc9e12024-03-19T04:19:04ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-06-0134102040Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltrationEmily S. Levine0Nikhil N. Batra1Section of Ophthalmology, Department of Surgery, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States; Corresponding author. Section of Ophthalmology, Department of Surgery Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, New Hampshire, United States.Section of Ophthalmology, Department of Surgery, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United StatesPurpose: To report the findings supported by multimodal imaging in a case of secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration. Observations: A 64-year-old man with systemic diffuse large B-cell lymphoma presented with reduced visual acuity. Moderate anterior chamber and vitreous cell were present. Fundus exam showed bilateral disc edema and diffuse opaque macular infiltrates with a pseudo cherry-red spot in the left eye. Optical coherence tomography showed inner retinal infiltration and loss of normal architecture. Surgery for tissue biopsy was discussed and declined due to risk. Instead, multimodal imaging and anterior chamber fluid sampling were used as a surrogate for tissue biopsy and helped rule out infectious uveitis and retinal vascular disease. The patient was empirically treated with intravitreal methotrexate with rapid improvement in vision, exam, and quality of life. Conclusions and importance: Multimodal imaging can support a presumed diagnosis of secondary vitreoretinal lymphoma in order to proceed with intravitreal methotrexate treatment, which can result in rapid clinical and visual improvement.http://www.sciencedirect.com/science/article/pii/S2451993624000501Vitreoretinal lymphomaRetinaIntravitreal methotrexateMultimodal imagingOptical coherence tomography |
| spellingShingle | Emily S. Levine Nikhil N. Batra Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration American Journal of Ophthalmology Case Reports Vitreoretinal lymphoma Retina Intravitreal methotrexate Multimodal imaging Optical coherence tomography |
| title | Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| title_full | Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| title_fullStr | Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| title_full_unstemmed | Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| title_short | Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| title_sort | multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration |
| topic | Vitreoretinal lymphoma Retina Intravitreal methotrexate Multimodal imaging Optical coherence tomography |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624000501 |
| work_keys_str_mv | AT emilyslevine multimodalimaginginacaseofpresumedsecondaryvitreoretinallymphomapresentingwithinnerretinaandopticnerveheadinfiltration AT nikhilnbatra multimodalimaginginacaseofpresumedsecondaryvitreoretinallymphomapresentingwithinnerretinaandopticnerveheadinfiltration |