Spectral-domain optical coherence tomographic and fundus autofluorescence findings in eyes with primary intraocular lymphoma
A 67-year-old man visited our clinic with blurred vision in the left eye of one month’s duration. He had been diagnosed with PCNSL one year earlier. Our ophthalmoscopic examination showed diffuse vitreous opacities and retinal infiltrations in the macular area. Diagnostic vitrectomy was performed, and cytodiagnosis revealed class III lymphoma cells. The IL-10/IL-6 ratio in the vitreous was 27.4, leading to a diagnosis of PIOL.\nThe decimal best-corrected visual acuity after vitrectomy was 0.15. Fundus examination revealed many large whitish yellow spots with indistinct boundaries in the macular area (). The FAF images showed hypoautofluorescence and hyperautofluorescence surrounding the spots with a honeycomb shape in the macular area (). Late phase FA showed hyperfluorescence of the disc and a fluorescence pattern of the retina that was the reverse of the FAF pattern (). The SD-OCT images showed hyper-reflective infiltrations at the level of the RPE, separation of Bruch’s membrane from the RPE, disruption of the IS/OS junction, hyper-reflective bands above the RPE, and hyper-reflective signals in the inner retina (). Magnetic resonance imaging showed that the PCNSL had not recurred. This patient was treated by intravitreal injection of methotrexate. After six injections, the retinal hyper-reflective infiltrations decreased in the SD-OCT images and the IL-10 level in aqueous humor was undetectable.