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RETINAL AND CHOROIDAL TUMORS

Intraocular Lymphoma

The spectrum of intraocular lymphoid tumors ranges from benign reactive lymphoid hyperplasia to various types of malignant lymphoma.

Intraocular lymphoma is commonly a non-Hodgkin’s large B cell lymphoma of the eye and the CNS.

The ocular findings include large clumps of cells in the vitreous, and the fundus examination is significant for multifocal, large, yellow, sub-retinal and sub-RPE infiltrative lesions.

Patients with intraocular lymphoma can be divided into several distinct subgroups, associated with: central nervous system non-Hodgkin’s lymphoma, systemic non-Hodgkin’s lymphoma, acquired immunodeficiency syndrome, and other rare forms of systemic lymphoma.

DIFFERENTIAL DIAGNOSIS of Intraocular-CNS Lymphoma:

Subretinal and Sub-RPE...

The spectrum of intraocular lymphoid tumors ranges from benign reactive lymphoid hyperplasia to various types of malignant lymphoma.

Intraocular lymphoma is commonly a non-Hodgkin’s large B cell lymphoma of the eye and the CNS.

The ocular findings include large clumps of cells in the vitreous, and the fundus examination is significant for multifocal, large, yellow, sub-retinal and sub-RPE infiltrative lesions.

Patients with intraocular lymphoma can be divided into several distinct subgroups, associated with: central nervous system non-Hodgkin’s lymphoma, systemic non-Hodgkin’s lymphoma, acquired immunodeficiency syndrome, and other rare forms of systemic lymphoma.

DIFFERENTIAL DIAGNOSIS of Intraocular-CNS Lymphoma:

Subretinal and Sub-RPE Infiltrates

  • Acute posterior multifocal placoid pigment epitheliopathy
  • Amelanotic choroidal melanoma
  • Bilateral diffuse uveal melanocytic proliferation
  • Birdshot retinochoroidopathy
  • Choroidal granuloma (e.g., sarcoidosis, tuberculosis)
  • Choroidal metastasis
  • Diffuse unilateral subacute neuroretinitis
  • Fundus flavimaculatus
  • Multifocal choroiditis
  • Multiple evanescent white dot syndrome
  • Pneumocystis choroiditis
  • Sympathetic ophthalmia
  • Vogt-Koyanagi-Harada syndrome

Retinal and Retinal Vascular Infiltrates

  • Fungal retinochoroiditis
  • Retinal periphlebitis (e.g., sarcoidosis, toxoplasmosis)
  • Retinal vascular occlusion
  • Retinal vasculitis (e.g., frosted branch angiitis, Behçet’s disease)
  • Toxoplasmosis
  • Viral retinitis (e.g., acute retinal necrosis, cytomegalovirus retinitis)

Vitreous

  • Amyloidosis
  • Intermediate or posterior uveitis
  • Old vitreous hemorrhage
  • Senile vitritis
  • Optic nerve
  • Infiltrative disease (e.g., leukemia, metastasis, granuloma)
  • Optic disc edema
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Clinical Cases