Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Department of Ophthalmology, Asahikawa Medical University, Hokkaido, Japan.
Jpn J Ophthalmol. 2024 Nov;68(6):722-730. doi: 10.1007/s10384-024-01102-1. Epub 2024 Sep 28.
To clarify the clinical features including multimodal imaging of primary choroidal lymphoma.
Retrospective, observational case series METHODS: Six consecutive patients with primary choroidal lymphoma diagnosed at Tokyo Medical University Hospital were studied. Demographic profile, clinical features and multimodal imaging were reviewed retrospectively.
The patients comprised 3 men and 3 women with average age of 68.2 ± 12.4 years. Clinical diagnosis before referring to our hospital included Vogt-Koyanagi-Harada disease, posterior scleritis, and choroidal hemangioma, and no patients had been diagnosed with choroidal lymphoma. Average duration from onset of ocular symptoms to establishing a diagnosis was 14.2 months. Ocular fundus examination revealed yellowish orange nummular infiltration in all six cases, and granular pigment deposits at the posterior pole in four cases. Optical coherence tomography showed increased choroidal thickness and waving of the retinal pigment epithelium in all cases. Ultrasonography depicted choroidal thickening and extraocular nodular lesions adjacent to the posterior sclera in all cases. None of the cases showed elevated interleukin-10 in the aqueous humor. Ocular fundus manifestations and visual acuity improved after external beam radiation therapy, except one case with bullous retinal detachment from the initial visit.
Characteristic ocular fundus manifestation together with multimodal imaging findings are useful for the clinical diagnosis of primary choroidal lymphoma.
阐明原发性脉络膜淋巴瘤的临床特征，包括多模态成像。
回顾性、观察性病例系列研究
研究了在东京医科大学医院诊断为原发性脉络膜淋巴瘤的 6 例连续患者。回顾性分析了人口统计学特征、临床特征和多模态成像。
患者包括 3 名男性和 3 名女性，平均年龄为 68.2±12.4 岁。在转诊至我院之前的临床诊断包括 Vogt-Koyanagi-Harada 病、后巩膜炎和脉络膜血管瘤，没有患者被诊断为脉络膜淋巴瘤。从眼部症状出现到确诊的平均时间为 14.2 个月。眼部眼底检查显示 6 例均出现黄褐色钱币状浸润，4 例后极有颗粒状色素沉着。光学相干断层扫描显示所有病例均有脉络膜增厚和视网膜色素上皮波动。超声检查显示所有病例均有脉络膜增厚和后巩膜邻近的眼外结节病变。所有病例的房水中均未检测到升高的白细胞介素-10。除一例从初诊时即出现大泡性视网膜脱离外，眼部眼底表现和视力在接受外照射后均有所改善。
特征性的眼部眼底表现和多模态成像结果有助于原发性脉络膜淋巴瘤的临床诊断。
