Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Ophthalmol. May 12, 2014; 4(2): 21-24
Published online May 12, 2014. doi: 10.5318/wjo.v4.i2.21
Presenting clinical features of patients with vitreoretinal lymphoma
Katie M Keck, David J Wilson, Eric B Suhler, Alison Skalet, Christina J Flaxel
Katie M Keck, David J Wilson, Eric B Suhler, Alison Skalet, Christina J Flaxel, Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, United States
Eric B Suhler, Ophthalmology Service, Portland VA Medical Center, Portland, OR 97239, United States
Author contributions: Keck KM carried out data collection, data analysis and drafted the manuscript; Flaxel CJ also carried out data collection; Wilson DJ, Suhler EB, Skalet A and Flaxel CJ were treating physicians and also carried out the correction of the manuscript; all authors read and approved the final manuscript.
Supported by Unrestricted departmental funding from Research to Prevent Blindness (New York, NY)
Correspondence to: Christina J Flaxel, MD, Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, 3375 SW Terwilliger Blvd, Portland, OR 97239, United States. flaxelc@ohsu.edu
Telephone: +1-503-4183352 Fax: +1-503-4183352
Received: December 9, 2013
Revised: February 24, 2014
Accepted: April 3, 2014
Published online: May 12, 2014
Processing time: 170 Days and 0.8 Hours
Abstract

AIM: To assess the presenting clinical features, time from presentation to diagnosis and association with central nervous system (CNS) lymphoma in patients with vitreoretinal lymphoma.

METHODS: Retrospective case series of patients diagnosed with vitreoretinal lymphoma between 2009 and 2011 at a single center.

RESULTS: Fifteen eyes in 9 patients were included. Common presenting ocular symptoms included blurred vision (78%) and worsening floaters (44%) with an average symptom duration prior to presentation of 88.4 d (range 7-365 d). Common ophthalmic exam findings were vitreous haze (89%) and subretinal lesions (56%). The average time from presentation to diagnosis was 56.3 d (range 16-180 d). All patients were diagnosed with large B-cell lymphoma according to pathology results. Lymphoma was restricted to the eye in 33%, while 67% of patients had CNS involvement. Of the patients with secondary vitreoretinal lymphoma, 67% initially presented with CNS lymphoma while 33% initially presented with vitreoretinal lymphoma. Of the patients with CNS involvement, memory loss (67%) was the most common presenting symptom.

CONCLUSION: Vitreoretinal lymphoma most commonly presents with symptoms of blurred vision and/or worsening floaters and vitreous haze on exam. The average time from presentation to diagnosis may be decreasing with increased awareness among clinicians.

Keywords: Primary vitreoretinal lymphoma; Secondary vitreoretinal lymphoma; Primary central nervous system lymphoma; Primary intraocular lymphoma

Core tip: Vitreoretinal lymphoma is a rare, highly malignant lymphoma that can present a diagnostic challenge to clinicians. This case series was designed to identify presenting clinical features associated with vitreoretinal lymphoma.