Primary central nervous system lymphoma with intraocular recurrence after optic nerve disorder

To describe a patient with primary central nervous system lymphoma (PCNSL) who developed intraocular recurrence after the onset of optic nerve disorder.

A 46-year-old woman developed bilateral central vision loss 1 year after the onset of PCNSL. Ophthalmologic examination, including perimetry, magnetic resonance imaging, and determination of visual evoked potential, was performed.

These examinations revealed a diagnosis of bilateral optic nerve disorder, and optic nerve disorder spontaneously resolved. Six months later, the patient had blurred vision in the left eye. Funduscopic examination revealed dense vitreous opacity and geographic subretinal exudates. Cytologic analysis of vitreous obtained by pars plana vitrectomy led to a diagnosis of recurrent intraocular lymphoma. The patient again developed brain recurrence 8 months after chemotherapy for intraocular recurrence.

The clinical course in this case suggests that lymphoma cells infiltrated from the brain into the eye along the optic nerve.