Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 30;14(1):69.
doi: 10.1186/s12348-024-00426-w.

Bilateral primary vitreoretinal lymphoma masquerading as fungal endophthalmitis- a case report

Manisha Agarwal  1 , Alankrita Muralidhar  2 , Tanya Jain  2 , Prashant Katre  2 , Arpan Gandhi  2 , Priyanka Gupta  3 , Charu Gupta  3 , Shishir Narain  3
Affiliations

Bilateral primary vitreoretinal lymphoma masquerading as fungal endophthalmitis- a case report

Manisha Agarwal et al. J Ophthalmic Inflamm Infect. .

Abstract

Purpose: 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.

Observation: 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.

Conclusion: 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.

Keywords: Interleukin (IL); Pars Plana Vitrectomy (PPV); Primary Vitreoretinal Lymphoma (PVRL); Retinal Pigment Epithelium (RPE); Spectral Domain Optical Coherence Tomography (SD-OCT).

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Consent to participate was obtained from the parents in a written manner. Consent for publication: Written informed consent was obtained from the patient's parent for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Fundus photograph of the right eye showing a sub retinal yellowish lesion and a very small yellowish leison at the macula of the left eye along with few hypopigmented spots
Fig. 2
Fig. 2
A SD-OCT of the RE through the posterior pole showed outer retinal and sub-RPE infiltrates. B Scan through the large temporal lesion showed homogenous, hyper-reflective deposits between the RPE and Bruch’s membrane. C SD-OCT of the LE showed few discrete RPE nodular infiltrates
Fig. 3
Fig. 3
A Drainage retinotomy being created at the tip of the lesion in the RE. B Soft tipped cannula use to aspirate the material for examination. C Endolaser being applied to the retinotomy site
Fig. 4
Fig. 4
Cytology smear from the sample showed small and large lymphoid cells in a background of necrotic cells with some of the large cells showing prominent nucleoli
Fig. 5
Fig. 5
Timeline of events in the right eye. The lesion is healing at 6 weeks and appears scarred at 6 months post injection
Fig. 6
Fig. 6
Timeline of events in the left eye. The lesion is healing at 6 weeks and appears scarred at 6 months post injection
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Chan CC, Sen HN (2013) Current concepts in diagnosing and managing primary vitreoretinal (intraocular) lymphoma. Discov Med 15(81):93–100 - PMC - PubMed
    1. Xu LT, Huang Y, Liao A, Anthony CL, Voloschin A, Yeh S (2022) Multimodal diagnostic imaging in primary vitreoretinal lymphoma. Int J Retina Vitre- ous 8(1):58 - PMC - PubMed
    1. Abrey LE, Ben-Porat L, Panageas KS, Yahalom J, Berkey B, Curran W, Schultz C, Leibel S, Nelson D, Mehta M, DeAngelis LM. Primary central nervous system lymphoma: the Memorial Sloan-Kettering Cancer Center prognostic model. J Clin Oncol. 2006;24(36):5711–5. 10.1200/JCO.2006.08.2941. - DOI - PubMed
    1. Cooper EL, Riker JL (1951) Malignant lymphoma of the uveal tract. Am J Ophthalmol. 34(8):1153–8 ([PubMed]) - PubMed
    1. Klingele TG, Hogan MJ (1975) Ocular reticulum cell sarcoma. Am J Ophthalmol. 79(1):39–47 ([PubMed]) - PubMed

LinkOut - more resources