Bilateral Combined Retinal Vascular Occlusion: An Ocular Presentation in Central Nervous System Re-relapse of Non-Hodgkins Lymphoma
Journal Title: Ophthalmology Research: An International Journal - Year 2016, Vol 5, Issue 4
Abstract
Aim: We describe an atypical case of central nervous system (CNS) involvement in non-Hodgkins lymphoma (NHL), presenting with ocular manifestations. Presentation: Here we present an extremely rare case of a 63 year old male with past history of relapsed NHL in remission with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, primarily presenting with bilateral sequential acute loss of vision without any systemic manifestations of relapse. On ophthalmological evaluation, he was found to have mixed central retinal artery and central retinal vein obstruction (CRAO & CRVO). CSF (cerebro-spinal fluid) evaluation revealed large B cell lymphoma cells. Management was initiated with triple intrathecal chemotherapy. Discussion: NHL is the commonest type of ocular lymphoma, which is often the first manifestation of systemic relapse in cases of previous therapy. However, CRVO secondary to NHL is extremely rare. To the best of our knowledge, there are no previous reports of bilateral CRVO as a result of re-relapse of DLBCL presenting with features of ophthalmoplegia. Conclusion: Re-relapse as isolated CNS lymphoma at second remission in a patient with systemic NHL is quite rare. Although unlikely, bilateral combined CRAO & CRVO may be the first manifestation of relapsed CNS lymphoma. Hence, clinicians should have a raised index of suspicion in cases of NHL presenting primarily with sudden, total loss of vision.
Authors and Affiliations
Amrita Chakrabarti, Priyanka Samal, Joydeep Chakrabartty
Keywords
Related Articles
- EP ID EP327572
- DOI 10.9734/OR/2016/26848
- Views 89
- Downloads 0
Osteogenic Osteosarcoma of the Orbit: A Case Report
Osteogenic osteosarcoma of the orbit is a rare and aggressive type of osteosarcoma. Head and neck osteosarcomas occur most commonly in the third and fourth decades and have equal sex predisposition. A 56-year-old male pa...
Reactivity against the Flavine Adenosine Nucleotide (FAD) Cofactor of Bacterial Enzymes May Explain Positive Flavoprotein Antibody Tests in Patients without Ophthalamopathy
Background: We have re-visited a possible role of autoantibodies targeting a "64 kDa muscle membrane protein" in the pathogenesis of thyroid-associated ophthalmopathy (TAO). This antigen was identified as the flavoprotei...
Combined Analysis of Safety and Optimal Efficacy in UV-light-activated Corneal Collagen Crosslinking
Aims: To analyze the combined factors for safety and optimal efficacy for UV-light-initiated corneal collagen cross-linking (CXL). Study Design: Modeling and analysis of CXL. Place and Duration of Study: New Vision Inc,...
Macular Thickness Measurement via Heidelberg Spectralis SD-OCT in Pediatric Patients
Aims: To determine the normative values of the macular thickness measurements via spectral-domain optical coherence tomography (SD-OCT) in healthy pediatrics. Study Design: Prospective study. Place and Duration of Study...
Relationship of Hemoglobin A1C and Outcomes of Treatment of Diabetic Macular Edema
Aims: To evaluate the relationship between Hemoglobin A1c (HbA1c) and visual and anatomical outcomes in eyes following treatment with intravitreal anti vascular endothelial growth factor (VEGF) agents and corticosteroids...