levoleucovorin and Optic-Atrophy

Primary intraocular lymphoma is a distinct subset of primary non-Hodgkin's lymphoma of the CNS. In general, the primary non-Hodgkin's lymphoma of the CNS is rare, accounting for 1 % of all non-Hodgkin's lymphomas and less than 1 % of all intraocular tumors.. A 70-year-old man was hospitalized in June 2002 because of acute loss of vision on his left eye. A severe vitreous hemorrhage was observed. Ultrasound showed solid subretinal lesions at the posterior fundus. Diagnostic vitreous surgery including a biopsy was performed. An intraocular malignant B-cell lymphoma was determined by immunohistochemistry. General screening revealed no further manifestations of the lymphoma.. The patient initially refused any therapy until a painful secondary neovascular glaucoma with complete loss of visual function developed, thus prompting us to perform an enucleation. The following immunohistochemical examination confirmed the initial diagnosis. A chemotherapy with high-dose methotrexate and leucovorin rescue was initiated.. Primary intraocular lymphoma can present as diffuse uveitis refractory to corticosteroids. Diagnosis can be difficult and is often delayed.

Topics: Aged; Biopsy; Blindness; Bruch Membrane; Chemotherapy, Adjuvant; Choroid; Choroid Neoplasms; Combined Modality Therapy; Drug Resistance, Neoplasm; Eye Enucleation; Follow-Up Studies; Humans; Leucovorin; Lymphoma, B-Cell; Male; Methotrexate; Optic Atrophy; Prognosis; Retina; Retinal Neoplasms; Vitrectomy; Vitreous Body; Vitreous Hemorrhage

Topics: Animals; Antibodies, Protozoan; Antiprotozoal Agents; Child; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Glucocorticoids; Humans; Immunocompetence; Immunoglobulin G; Leucovorin; Magnetic Resonance Imaging; Male; Optic Atrophy; Prednisone; Pyrimethamine; Retinitis; Sulfadiazine; Toxoplasma; Toxoplasmosis, Ocular