Riazi-Esfahani Hamid, Hassanpoor Narges, Ghassemi Fariba, Zarei Mohammad
Retina and Vitreous Service, Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Curr Ophthalmol. 2020 Apr 30;32(2):207-210. doi: 10.4103/JOCO.JOCO_106_20. eCollection 2020 Apr-Jun.
To describe a case of primary vitreoretinal lymphoma (PVRL) that initially presented and managed as dry type age-related macular degeneration (AMD).
A 69-year-old male was referred to us by decreased vision.
On funduscopy, a few small hard drusen at the posterior pole of the right eye and many large confluent drusen in the left eye were observed. Optical coherence tomography findings included the hyperreflective drusenoid materials in the subretinal pigment epithelium (sub- RPE) space which was similar to previous imaging records except for decreased area and height of pigment epithelial detachments and RPE and ellipsoid zone attenuation in some areas appeared. The thickness of the retina was normal, but the choroid appeared to be slightly decreased compared to the left eye. Patient has been followed up with the diagnosis of AMD for 1 year. After the right hemiparesis presentation, he underwent craniotomy and biopsy that made the diagnosis evident.
PVRL/primary central nervous system lymphoma may be one of the most important masquerades of AMD, but a significantly waxing and waning course may help to make correct diagnosis.
描述一例最初表现为干性年龄相关性黄斑变性(AMD)并按此进行处理的原发性玻璃体视网膜淋巴瘤(PVRL)病例。
一名69岁男性因视力下降被转诊至我院。
眼底检查发现,右眼后极部有少量小的硬性玻璃膜疣,左眼有许多大的融合性玻璃膜疣。光学相干断层扫描结果显示,视网膜色素上皮(RPE)下空间存在高反射性类玻璃膜疣物质,这与之前的影像学记录相似,但色素上皮脱离的面积和高度减小,部分区域出现RPE和椭圆体带衰减。视网膜厚度正常,但与左眼相比,脉络膜似乎略有变薄。该患者被诊断为AMD并随访了1年。右侧偏瘫出现后,他接受了开颅手术和活检,从而明确了诊断。
PVRL/原发性中枢神经系统淋巴瘤可能是AMD最重要的伪装之一,但病情显著波动的病程可能有助于做出正确诊断。