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AN INFILTRATIVE CHOROIDAL LESION
Yanliang Li1, Hesham Gabr, William F Mieler
1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Purpose:
To present a distinctive case of primary choroidal lymphoma diagnosed by choroidal biopsy with myeloid differentiation primary response 88 testing.
Methods:
We describe the case of a 55-year-old man with unilateral progressive blurry vision. Fundus examination found a whitish/yellowish infiltrative lesion in the posterior pole with macular edema, which had interval improvement with oral prednisone, followed by worsening on optical coherence tomography with persistent subretinal hyper-reflective materials.
Results:
Because the initial pars plana vitrectomy/vitreous biopsy and choroidal fine needle aspiration biopsy were inconclusive, the second fine needle aspiration biopsy was performed with an additional myeloid differentiation primary response 88 genetic test that revealed a rare in-frame deletion of myeloid differentiation primary response 88 (p.D288_T294del) in the choroidal sample.
Conclusion:
The diagnosis of primary choroidal lymphoma was eventually established. After treatment with methotrexate, followed by external beam radiotherapy, the choroidal infiltrate was normalized on B scan.
