Spontaneous Regression of Vitreoretinal Lymphoma Lesions: Case Series and Literature Review

To describe a case series of spontaneous regression of vitreoretinal lymphoma (VRL) lesions documented through multimodal imaging and to contextualize findings with a review of the literature.

We report five Caucasian patients with biopsy-confirmed VRL. All patients underwent multimodal imaging, including spectral-domain optical coherence tomography (SD-OCT), ultra-widefield (UWF) pseudocolor, and autofluorescence (AF) imaging, and fluorescein angiography (FA). Clinical and imaging data were reviewed to assess the occurrence of spontaneous lesion regression.

Spontaneous regression of VRL lesions was observed both in treatment-naïve patients and in patients under surveillance following prior systemic or intravitreal therapy. In one case, bilateral regression of optic nerve infiltration was observed; in two cases, unilateral regression of subretinal or sub-RPE lesions occurred; and in two cases, retinitis-like lesions spontaneously regressed.

Spontaneous regression of VRL is a rare but clinically relevant phenomenon that may follow diagnostic interventions such as vitrectomy, possibly via immune-mediated mechanisms. Multimodal imaging is essential for documenting regression and guiding clinical management. Awareness of this phenomenon may prevent misinterpretation of disease activity and inform the need for close follow-up, even when apparent lesion regression occurs.