Rapid, Spontaneous Resolution Of Prominent Subretinal Infiltrate In Vitreoretinal Lymphoma
Gong D, Aronow ME, Eliott D. Rapid, Spontaneous Resolution of Prominent Subretinal Infiltrate in Vitreoretinal Lymphoma. Journal of VitreoRetinal Diseases. 2021;6(1):80-85. doi:10.1177/24741264211009804
View Original Source →Abstract
Purpose: This case report describes a patient with vitreoretinal lymphoma who subacutely developed a large, peripapillary subretinal infiltrate that rapidly and spontaneously resolved. Methods: A case report is presented. Results: A 65-year-old Asian-American woman was referred for evaluation of a dense, peripapillary subretinal infiltrate in the left eye. A diagnostic vitrectomy revealed large, atypical lymphocytes with irregularly shaped nuclei, and mutational testing was positive for myeloid differentiation primary response 88 ( MYD88). Prior to surgery, the patient’s subretinal infiltrate had begun to resolve spontaneously, a process that continued after surgery without initiation of systemic or local ocular therapy. Conclusions: Patients with vitreoretinal lymphoma may present with transient, subretinal infiltrates that can resolve without treatment.
Case Details
Disease Location
Vitreous (vitreoretinal lymphoma)
Personal Characteristics
65-year-old asian-american, hypertension
Clinical Characteristics
Complaining of blurry vision and floaters in both eyes for 1 year and acute onset of flashes in the left eye for 1 week. She was diagnosed with a hemorrhagic posterior vitreous detachment (pvd) in the left eye and was instructed to follow up in 1 month. At her 1-month follow-up, a new lesion was noted in her left eye. Visual acuity was 20/20 in the right eye and 20/40 in the left eye. Confrontation visual field testing showed inferotemporal field loss in the left eye. Ishihara color vision test results were reduced (5 of 10 plates) in the left eye. Slitlamp examination showed an absence of anterior chamber cells in both eyes but revealed 1þ vitreous cell in the right eye and 2þ vitreous cell with a pvd in the left eye. Dilated fundus examination was notable for numerous small, discrete subrpe lesions in the periphery of the right eye and a large peripapillary, white subretinal infiltrate with numerous small, discrete subrpe lesions in the superior macula and periphery of the left eye. The patient was scheduled for a diagnostic pars plana vitrectomy (ppv).
Remission Characteristics
At her preoperative examination 1 week after initial presentation, the peripapillary subretinal lesion demonstrated central clearing with migration into the macula and involve- ment of the subfoveal space
Treatment & Mechanisms
Proposed Remission Mechanisms
Subretinal vrl involvement can develop subacutely and can resolve over a short period of time
Clinical Treatment
Diagnostic pars plana vitrectomy (after remission)