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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Primary Intraocular Lymphoma: Rad-Path and Ophthalmologic Correlation.

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Primary intraocular lymphoma (PIOL) is challenging to diagnose due to vague symptoms and imaging. This case series highlights diagnostic complexities and treatment approaches for PIOL, emphasizing imaging

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Area of Science:

  • Ophthalmology
  • Oncology
  • Radiology

Background:

  • Primary intraocular lymphoma (PIOL) is a rare, difficult-to-diagnose ocular malignancy.
  • Nonspecific clinical and complex imaging features complicate PIOL identification.
  • PIOL can indicate or precede central nervous system (CNS) involvement.

Purpose of the Study:

  • To present a case series of primary intraocular lymphoma (PIOL).
  • To highlight diagnostic challenges and treatment strategies for PIOL.
  • To emphasize the role of imaging in PIOL diagnosis and management.

Main Methods:

  • Case series review of three patients with PIOL.
  • Clinical examination, funduscopy, and magnetic resonance imaging (MRI).
  • Diagnostic confirmation via transvitreal biopsy, cytology, immunohistochemistry, and flow cytometry.

Main Results:

  • Focus case: 66-year-old male with vision loss diagnosed with PIOL via biopsy, treated with steroids and rituximab.
  • Companion case 1: 66-year-old female with suspected PIOL treated with radiation.
  • Companion case 2: 63-year-old male diagnosed with PIOL and Richter transformation, treated with enucleation.

Conclusions:

  • Accurate diagnosis of PIOL is crucial due to potential CNS spread.
  • Diagnostic imaging, including MRI, is vital for assessing disease extent.
  • Treatment strategies for PIOL are individualized based on disease extent and CNS involvement.