Background: Iris involvement in intraocular lymphoma (IOL) is extremely rare. Herein, we mainly report the clinical features in three cases of secondary IOL with mass formation due to lymphoma invasion into the iris.
Cases: The patients were one male and two females with a mean age of 63 years. All patients had a history of diffuse large B-cell lymphoma in the organ excluding the eye and central nervous system (adrenal glands, orbit, and neck), and all of them were in remission when the ocular lesions onset. All patients had inflammation in the anterior chamber and vitreous opacity, and two patients showed yellow-white retinal lesions. All patients underwent vitreous biopsy for diagnosis. Although one patient had an interleukin (IL)-10/IL-6 ratio in vitreous humor>1, cytology, flow cytometry, and polymerase chain reaction (PCR) (genetic reconstruction) did not show any characteristic findings of IOL in any of the cases. Two patients received methotrexate intravitreal injection (MTX-IV) and one patient received steroid-based treatment. All three patients responded to treatment, but they showed mass formation in the iris as recurrence of IOL from 1 to 4 years after the initial treatment. Although MTX-IV was resumed in two patients, one patient showed resistance to MTX-IV and no reduction in iris formation was observed. Systemic examination was performed again and revealed extraocular lesions in all patients; therefore, they underwent systemic chemotherapy.
Conclusions: We studied three cases of secondary IOL with mass formation in the iris. In all cases, extraocular lesions occurred simultaneously with iris mass formation, requiring systemic chemotherapy for treatment.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 87-95,2024.