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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Vitreoretinal lymphoma: a diagnostic challenge
Journal Information
Vol. 98. Issue 12.
Pages 718-722 (December 2023)
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Vol. 98. Issue 12.
Pages 718-722 (December 2023)
Short communication
Vitreoretinal lymphoma: a diagnostic challenge
Linfoma vitreoretiniano: un reto diagnóstico
E. Sáenz Deckera,
Corresponding author
elensdeck@gmail.com

Corresponding author.
, M. García Fernándeza, R. Gómez De la Torreb, R. Coto Hernándezb, L.I. Santana Garcíaa
a Servicio de Oftalmologia, Hospital Universitario Central de Asturias, Oviedo, Spain
b Servicio de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Spain
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Abstract

A 66-year-old man with posterior uveitis and recurrent cystic macular edema related to possible previously treated Lyme disease is presented. Due to the recurrence of macular edema despite systemic and local corticosteroid treatment with intravitreal dexamethasone, biological treatment with Adalimumab was established. During follow-up, the patient developed bilateral subretinal lesions compatible with Vitreoretinal Lymphoma (VRL), so vitrectomy was performed, confirming the diagnosis of large B-cell lymphoma.

Treatment with systemic chemotherapy with BRAM-Carmustine, Metrotexate, Ara C, and Rituximab was started with a good answer. Two years later, the patient remains without ocular or systemic recurrences.

Vitreoretinal Lymphoma is a rare type of primary central nervous system lymphoma. The diagnosis is frequently delayed due to the nonspecific symptoms, which mimic chronic posterior uveitis, hence the importance with a diagnostic suspicion.

Keywords:
Vitreoretinal lymphoma
Posterior uveitis
Vitritis
Vitrectomy
Resumen

Se presenta el caso de un varón de 66 años remitido por uveítis posterior con edema macular quístico recurrente en relación con posible enfermedad de Lyme previamente tratada. Debido a la recurrencia del edema macular pese al tratamiento corticoideo sistémico y local con dexametasona intravítrea, se instaura tratamiento biológico con Adalimumab. Durante el seguimiento el paciente desarrolla lesiones subretinianas bilaterales compatibles con Linfoma Vitreorretiniano (LVR), por lo que se realiza vitrectomía confirmando el diagnóstico de linfoma de célula B grande.

Se inicia tratamiento con quimioterapia sistémica con BRAM- Carmustina, Metrotexate, Ara C y Rituximab, con buena respuesta. Dos años después, el paciente permanece sin recurrencias a nivel ocular ni sistémico.

El Linfoma Vitreoretiniano es un tipo poco frecuente de linfoma primario del sistema nervioso central. El diagnóstico se ve frecuentemente retrasado debido a la inespecificidad de su sintomatología, que simula una uveítis posterior crónica, de ahí la importancia de la sospecha diagnóstica.

Palabras clave:
Linfoma vitreorretiniano
Uveítis posterior
Vitritis
Vitrectomía

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