Pal Bikramjit P, Palosaari Tapani, Kivelä Tero
Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Vitreoretinal Service, Department of Ophthalmology, Oulu University Hospital, Oulu, Finland.
Retin Cases Brief Rep. 2019;13(1):67-71. doi: 10.1097/ICB.0000000000000535.
To highlight the course of blood-brain barrier disruption maculopathy in a patient with successfully managed relapsed central nervous system lymphoma.
Case report with fundus autofluorescence and optical coherence tomography imaging, and literature review.
A 57-year-old patient diagnosed with central nervous system large B-cell lymphoma had a normal ophthalmic evaluation on his first visit. Subsequently, when his malignancy recurred locally, he was started on blood-brain barrier disruption therapy and intraarterial methotrexate. During the course of the therapy, he developed bilateral retinal pigment epithelial abnormalities located in the foveal and perifoveal zones. The changes were first mildly progressive and then marginally regressive in nature with minimal eventual loss of visual acuity to 20/32 and 20/25 in his right and left eye, respectively.
Maculopathy is a known complication in patients with central nervous system malignancies undergoing blood-brain barrier disruption. A detailed clinical evaluation using fundus autofluorescence and high-definition optical coherence tomography are informative in managing such patients.
强调在一名成功治疗复发性中枢神经系统淋巴瘤患者中血脑屏障破坏相关性黄斑病变的病程。
病例报告，伴有眼底自发荧光和光学相干断层扫描成像，并进行文献综述。
一名57岁被诊断为中枢神经系统大B细胞淋巴瘤的患者初次就诊时眼科检查正常。随后，当他的恶性肿瘤局部复发时，开始接受血脑屏障破坏治疗和动脉内注射甲氨蝶呤。在治疗过程中，他出现了位于黄斑中心凹和黄斑中心凹周围区域的双侧视网膜色素上皮异常。这些变化最初呈轻度进展，随后呈轻微消退，最终右眼和左眼视力分别轻度下降至20/32和20/25。
黄斑病变是接受血脑屏障破坏治疗的中枢神经系统恶性肿瘤患者的一种已知并发症。使用眼底自发荧光和高清光学相干断层扫描进行详细的临床评估有助于管理此类患者。
