Purpose: To report the two cases of vitreo-retinal lymphoma (VRL) for which retinal biopsy was effective for diagnosis.
Cases: Case1 was a 66-year-old female presenting with progressive blurred vision in her right eye. One year ago, she had been diagnosed with primary central nervous system lymphoma, but she was in complete post-treatment remission. Fundus examination revealed a white subretinal lesion in her right eye, and vitreous biopsy was performed to elucidate whether it was VRL. The ratio of interleukin (IL)-10/IL-6 in the vitreous sample was elevated, but cytological examination and immunoglobulin heavy-chain gene rearrangement analysis findings were inconclusive. Approximately 2 months later, a fundus lesion appeared in her left eye, and optical coherence tomography (OCT) revealed an intraretinal lesion. Retinal biopsy was then performed because of a lack of vitreous opacity, revealed large B-cell infiltration, leading to a diagnosis of VRL. Case2 was a 77-year-old female who presented with a white retinal lesion in her left eye. She was in complete post-treatment remission after treatment for primary diffuse large B-cell lymphoma of left axillary lymph nodes. She was referred after a white lesion appeared after vitreous surgery performed 1 year ago for vitreous hemorrhage in her left eye. OCT revealed an intraretinal lesion. A diagnosis of VRL seemed unlikely based on vitreous biopsy of that eye because it was after vitreous surgery. A retinal biopsy revealed large Bcell infiltration, leading to a diagnosis of VRL.
Conclusion: The study findings revealed that retinal biopsy is effective for diagnosing VRL with an intraretinal lesion, especially in patients who have undergone vitreous surgery or who have no vitreous cells.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 312-318, 2018.