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 right eye of 3 months’ duration. He had been diagnosed with PCNSL 3 years earlier. Our initial examination showed iritis, mutton fat keratic precipitates, vitreous opacities, retinal infiltrations, and retinal vasculitis. Diagnostic vitrectomy was performed, and cytodiagnosis showed class V lymphoma cells. The IL-10/IL-6 ratio in the vitreous was 12.0. Thus, a diagnosis of PIOL was made.\nHis best-corrected visual acuity after vitrectomy was hand motion. Fundus examination revealed diffuse infiltration into the macular area and retinal vasculitis in the temporal and nasal areas (). Late phase fluorescein angiography (FA) showed hypofluorescent spots with a leopard spot-like pattern in the posterior fundus, and staining of the arteries with an avascular area in the nasal area (). SD-OCT examination showed nodular hyper-reflective infiltrations at the level of the RPE, a separation of Bruch’s membrane from the RPE, partial destruction of the RPE, disruption of the photoreceptor inner segment/outer segment (IS/OS) junction line, and hyper-reflective signals in the inner retina (). A layered structure of the retina could not be detected on the temporal side. FAF examinations were not performed in this case.\nThe patient was treated by intravitreal injection of methotrexate. After six injections, the retinal hyper-reflective infiltrations decreased in the SD-OCT images, and the level of IL-10 in the aqueous humor became undetectable. Recurrence of PCNSL was not found.