Clinical features and multimodal imaging of primary choroidal lymphoma

To clarify the clinical features including multimodal imaging of primary choroidal lymphoma.

Retrospective, observational case series METHODS: Six consecutive patients with primary choroidal lymphoma diagnosed at Tokyo Medical University Hospital were studied. Demographic profile, clinical features and multimodal imaging were reviewed retrospectively.

The patients comprised 3 men and 3 women with average age of 68.2 ± 12.4 years. Clinical diagnosis before referring to our hospital included Vogt-Koyanagi-Harada disease, posterior scleritis, and choroidal hemangioma, and no patients had been diagnosed with choroidal lymphoma. Average duration from onset of ocular symptoms to establishing a diagnosis was 14.2 months. Ocular fundus examination revealed yellowish orange nummular infiltration in all six cases, and granular pigment deposits at the posterior pole in four cases. Optical coherence tomography showed increased choroidal thickness and waving of the retinal pigment epithelium in all cases. Ultrasonography depicted choroidal thickening and extraocular nodular lesions adjacent to the posterior sclera in all cases. None of the cases showed elevated interleukin-10 in the aqueous humor. Ocular fundus manifestations and visual acuity improved after external beam radiation therapy, except one case with bullous retinal detachment from the initial visit.

Characteristic ocular fundus manifestation together with multimodal imaging findings are useful for the clinical diagnosis of primary choroidal lymphoma.