Exudative retinal detachment in castleman disease

Area of Science:

• Ophthalmology
• Hematology
• Oncology

Background:

• Castleman disease (CD) is a rare lymphoproliferative disorder.
• CD can present with diverse clinical manifestations, including ocular involvement.
• Visual symptoms and retinal disease are uncommon but significant presentations of CD.

Purpose of the Study:

• To document a case of Castleman disease presenting with visual disturbances.
• To describe the ocular findings, specifically retinal disease, in a patient with CD.
• To illustrate the management and outcome of retinal manifestations in CD.

Main Methods:

• Comprehensive clinical examination and fundus photography.
• Advanced imaging techniques including fluorescein and indocyanine green angiography.
• Diagnostic workup involving CT scans, blood tests, lymph node biopsy, and renal biopsy.

Main Results:

• A patient diagnosed with Castleman disease exhibited bilateral exudative retinal detachments.
• Systemic treatment with steroids for CD was initiated.
• Renal failure occurred during treatment but was successfully managed with plasmapheresis.
• The exudative retinal detachments resolved spontaneously within four weeks of systemic treatment initiation, without local ocular intervention.

Conclusions:

• Exudative retinal detachments can be a manifestation of Castleman disease.
• Systemic treatment for Castleman disease may lead to the resolution of associated retinal detachments.
• Observation of retinal changes under systemic therapy is a viable approach before considering local ocular treatments for CD-related retinal disease.