Agarwal Manisha, Muralidhar Alankrita, Jain Tanya, Katre Prashant, Gandhi Arpan, Gupta Priyanka, Gupta Charu, Narain Shishir
Dr Shroff's Charity Eye Hospital, 5072, Kedarnath Road, Daryaganj, New Delhi, 110002, India.
Shroff Eye Center, Kailash Colony, New Delhi, India.
J Ophthalmic Inflamm Infect. 2024 Dec 30;14(1):69. doi: 10.1186/s12348-024-00426-w.
To report a case of bilateral primary vitreoretinal lymphoma (PVRL) masquerading as endophthalmitis in a patient with a history of bilateral cataract surgery and COVID-19.
A 60-year-old male patient presented with diminution of vision in both the eyes. There was a history of bilateral cataract surgery done 2 months back at a gap of one week and COVID-19 infection treated with high dose systemic corticosteroids. Patient presented with dense vitritis with yellowish sub-retinal pigment epithelium (RPE) deposits in both the eyes six weeks after cataract surgery. It was clinically suspected to be endophthalmitis. Diagnostic vitrectomy was done in both the eyes and vitreous sample was negative on microbiological and cytological examination. Multimodal imaging along with sub retinal biopsy helped in confirming the diagnosis. Management was done using multiple intravitreal methotrexate injections and remission was achieved.
Vitritis with sub-RPE yellowish deposits may be mistaken for infectious endophthalmitis specially in a patient with a history of intraocular surgery or immunosuppression. PVRL is a great masquerader and is to be kept in mind while diagnosing a middle-aged patient with infectious or non-infectious uveitis.
报告一例双侧原发性玻璃体视网膜淋巴瘤（PVRL）伪装成眼内炎的病例，该患者有双侧白内障手术史及新冠病毒病（COVID-19）病史。
一名60岁男性患者出现双眼视力下降。2个月前患者接受了双侧白内障手术，手术间隔1周，且曾因新冠病毒病感染接受大剂量全身糖皮质激素治疗。白内障手术后6周，患者双眼出现浓密的玻璃体炎，并伴有视网膜色素上皮（RPE）下淡黄色沉积物。临床怀疑为眼内炎。对双眼进行了诊断性玻璃体切除术，玻璃体样本的微生物学和细胞学检查均为阴性。多模式成像及视网膜下活检有助于确诊。采用多次玻璃体内注射甲氨蝶呤进行治疗，病情缓解。
RPE下有淡黄色沉积物的玻璃体炎可能会被误诊为感染性眼内炎，尤其是有眼内手术史或免疫抑制的患者。PVRL极易伪装，在诊断中年感染性或非感染性葡萄膜炎患者时应予以考虑。
