Matsuo T, Yamaoka A, Shiraga F, Matsuo N
Department of Ophthalmology, Okayama University Medical School, Okayama City, Japan.
Retina. 1998;18(4):301-7. doi: 10.1097/00006982-199807000-00002.
To study initial ocular manifestations of ocular-central nervous system (CNS) lymphoma.
The authors reviewed medical records of 10 consecutive patients with intraocular-CNS lymphoma seen at Okayama University Hospital during 16 years from 1981 to 1996.
Three patients showed only vitreous opacity as an initial sign, whereas five other patients had typical yellowish-white infiltrates at the sub-retinal pigment epithelial (sub-RPE) level without vitreous opacity. Both manifestations were found in two patients. In seven patients, ocular symptoms developed first, followed by brain lesions. In contrast, in three patients the initial presentation was brain tumor, for which they received chemotherapy; subsequently, vitreous opacity without sub-RPE infiltrates developed. The diagnosis was made by vitrectomy in four patients, three of whom had also undergone brain biopsy; by aqueous tap in one; and by brain biopsy in one. The other four patients were diagnosed clinically, and one of them was confirmed later to have lymphoma by autopsy.
The initial ocular manifestations of intraocular-CNS lymphoma were of two types, sub-RPE infiltrates and vitreous opacity. Keeping these two manifestations in mind will help physicians consider a diagnosis of intraocular-CNS lymphoma earlier.
研究眼-中枢神经系统（CNS）淋巴瘤的初始眼部表现。
作者回顾了1981年至1996年期间在冈山大学医院连续就诊的10例眼内-CNS淋巴瘤患者的病历。
3例患者最初仅表现为玻璃体混浊，而另外5例患者在视网膜色素上皮（RPE）下水平有典型的黄白色浸润，无玻璃体混浊。2例患者同时出现这两种表现。7例患者眼部症状先出现，随后出现脑部病变。相反，3例患者最初表现为脑肿瘤，接受了化疗；随后出现无RPE下浸润的玻璃体混浊。4例患者通过玻璃体切除术确诊，其中3例还接受了脑活检；1例通过房水穿刺确诊；1例通过脑活检确诊。其他4例患者通过临床诊断，其中1例后来经尸检证实患有淋巴瘤。
眼内-CNS淋巴瘤的初始眼部表现有两种类型，即RPE下浸润和玻璃体混浊。牢记这两种表现将有助于医生更早地考虑眼内-CNS淋巴瘤的诊断。
