MULTIPLE RETINAL PIGMENT EPITHELIUM APERTURES ASSOCIATED WITH PSEUDO-VITELLIFORM LYMPHOMATOUS MACULOPATHY.

Area of Science:

• Ophthalmology
• Oncology
• Medical Imaging

Background:

• Vitreoretinal lymphoma (VRL) is a rare intraocular malignancy.
• Macular involvement in VRL can present with diverse clinical features.
• Accurate diagnosis and understanding of VRL manifestations are crucial for patient management.

Observation:

• A 66-year-old male with bilateral VRL presented with a unique pseudo-vitelliform macular lesion.
• Optical coherence tomography (OCT) revealed subretinal material, RPE thickening, detachment, and multiple RPE apertures.
• The lesion spontaneously resolved within 15 days, leaving outer retinal atrophy and cystoid macular edema.

Findings:

• The macular lesion showed isoautofluorescence and resolved rapidly.
• Retinal pigment epithelium (RPE) apertures were observed, a novel finding in VRL.
• Visual acuity declined from 20/20 to 20/100 after lesion resolution.

Implications:

• The described macular lesion may indicate VRL macular infiltration or paraneoplastic cloudy vitelliform submaculopathy.
• RPE apertures, previously undescribed in VRL, may not be specific to this condition.
• This case expands the spectrum of VRL ocular manifestations and diagnostic considerations.