Acquired Immunodeficiency Syndrome–Related Intraocular B-Cell Lymphoma

Abstract

To present the full clinical spectrum of the acquired immunodeficiency syndrome-related intraocular lymphoma as manifested in the eye, specifically retinal lymphoma associated with primary central nervous system lymphoma, isolated ocular lymphoma, and choroidal lymphoma associated with systemic lymphoma. Methods: Three patients with acquired immunodeficiency syndrome were noted to have atypical retinal lesions. Diagnostic retinal biopsy in 2 patients and postmortem examination of the eyes in the third case were performed. Results: Diagnostic retinal biopsy in the first 2 patients revealed retinal B-cell lymphoma. Initial systemic evaluation showed the eyes to be the sole site of disease. Later,

Ocular adnexal non-Hodgkin’s lymphoma: a review of epidemiology and risk factors

“…The type of ophthalmic disease among AIDS patients depends on the level of immune function and the extent of disease as well as opportunistic infections with EBV, HHV or Toxoplasma gondii. Intraocular lymphomas among AIDS patients have been described in a few case reports [99–101]. The most common presentation is a primary CNS lymphoma with ocular involvement characterized by vitreitis and subretinal (choriodal) infiltrates; diffuse large B-cell subtypes appear to predominate where described [99–102].…”

“…Intraocular lymphomas among AIDS patients have been described in a few case reports [99–101]. The most common presentation is a primary CNS lymphoma with ocular involvement characterized by vitreitis and subretinal (choriodal) infiltrates; diffuse large B-cell subtypes appear to predominate where described [99–102]. The role of HIV in ocular adnexal etiology needs further investigation.…”

Primary Intraocular Lymphoma

“…123 This increase was initially thought to be due to increased numbers of immunocompromised patients, but since the introduction of highly active antiretroviral therapy, the incidence in patients with the acquired immune deficiency syndrome (AIDS) has declined. 93,155,172,189 Iatrogenic immunosuppression may also lead to PIOL. 39,49,120,126,173,218 The cause for the increased incidence in immunocompetent patients is unknown.…”

Uveitis in HIV positive patients

“…3 Conditions associated with uveitis in HIV positive patients include opportunistic infections, such as cytomegalovirus (CMV) retinitis4 and herpes zoster ophthalmicus (HZO),5 unusual neoplasms, such as intraocular lymphoma,6 and possibly inflammation due to HIV infection itself 7. These complications are usually observed during advanced stages of disease, most often as CD4+ T lymphocyte counts drop below 50 cells ×10 6 /l 8.…”

“…22 Pneumocystis carinii often affects the lungs, whereas Cryptococcus has an affinity for the meninges, and frequently produces increased intracranial pressure and secondary swelling of the optic discs. Intraocular lymphoma is uncommon but appears to occur with increased frequency in HIV positive patients 6. A strong clue to the diagnosis includes the presence of vitreous inflammation, retinitis, or retinal vasculitis that responds only transiently or incompletely to corticosteroids.…”