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DIFFUSE LARGE B-CELL LYMPHOMA-ASSOCIATED-RETINOPATHY CHARACTERIZED BY MINIMAL MORPHOLOGIC CHANGES AND SEVERE
Laura Moyal1, Olivia Zambrowski, Charles Thirkill
1*Department of Ophthalmology, Intercommunal hospital of Creteil, Creteil, France; †Department of Ocular Immunology, University of California, Davis, California; ‡Lymphoid Malignancies Unit, Henri Mondor Hospital, Creteil, France; and §Hematology Department, University Paris Est, Creteil, France.
A patient with vision loss 30 years after Hodgkin lymphoma treatment was diagnosed with diffuse large B-cell lymphoma. This case highlights a rare, late-onset association between lymphoma and retinal disease.
Area of Science:
- Ophthalmology
- Oncology
- Hematology
Background:
- A 69-year-old male presented with progressive bilateral vision loss, color vision deficits, and photophobia.
- Initial ophthalmological examinations revealed no gross abnormalities, but advanced imaging showed ellipsoid layer attenuation and subfoveal defects on SD-OCT.
Observation:
- Electroretinogram (ERG) indicated bilateral cone-rod dysfunction.
- Despite minimal ocular findings, the patient's history of Hodgkin lymphoma and severe vision loss prompted investigation for a neoplastic etiology.
Findings:
- A massive mediastinal tumor was identified via CT scan, leading to a diagnosis of Stage IV non-Hodgkin lymphoma (diffuse large B-cell lymphoma).
- Serum analysis revealed abnormal retinal antibody activity, suggesting a paraneoplastic or direct neoplastic link.
Implications:
- This case underscores the importance of considering late-onset systemic malignancies, such as diffuse large B-cell lymphoma, in patients with unexplained retinal dysfunction.
- The findings emphasize the need for thorough oncological workup in patients with a history of lymphoma presenting with atypical visual symptoms.
