Spectral-domain optical coherence tomographic and fundus autofluorescence findings in eyes with primary intraocular lymphoma
A 57-year-old man visited our clinic with blurred vision in his left eye of one month’s duration. The initial examination showed diffuse vitreous opacities and retinal infiltrations. Diagnostic vitrectomy was performed, and cytodiagnosis revealed atypical class V lymphocytes with dyskaryosis and aberrant chromatin (). The IL-10/IL-6 ratio of the vitreous was 30.9. Thus, a diagnosis of PIOL was made.\nThe best-corrected visual acuity after vitrectomy was 1.0. Fundus examination revealed many small, yellow lesions with distinct boundaries resembling drusen in the posterior fundus (). A granular pattern of hypoautofluorescence and hyperautofluorescence was seen in the FAF images (). Late phase FA showed hyperfluorescence of the disc and small spots in the posterior fundus that corresponded to the hypofluorescent spots in the FAF images (). SD-OCT showed nodular hyper-reflective infiltrations at and above the level of the RPE, a separation of Bruch’s membrane from the RPE, partial destruction of the RPE and IS/OS junction, and multiple hyper-reflective signals in the inner retina (). PCNSL was not detected by magnetic resonance imaging. The patient was treated by intravitreal injection of methotrexate. After four injections, the retinal hyper-reflective infiltrations decreased in the SD-OCT images and the level of IL-10 in the aqueous humor became undetectable.