Retinal Involvement in Uveitis Associated With Hodgkin Disease

Ohta, Kouichi; Yoshida, Akiko; Sato, Atsuko; Fukui, Emi; Kikuchi, Takanobu

doi:10.1097/icb.0b013e3182a489f1

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…Paraneoplastic AIR is further subdivided into cancer-associated retinopathy (CAR) and melanoma-associated retinopathy (MAR) [1] , [2] , [3] , [4] , [5] . Lymphoma associated retinopathy (LAR) has also been described [6] , [7] , [8] . Nonparaneoplastic AIR is more common than pAIR [1] , [3] , [4] .…”

Section: Introductionmentioning

confidence: 99%

Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy

Uludağ

Onal

Arf

et al. 2016

American Journal of Ophthalmology Case Reports

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PurposeTo describe the effect of rituximab on full-field electroretinography (ERG) in a patient with nonparaneoplastic autoimmune retinopathy (npAIR).ObservationsA 58-year-old male patient with visual complaints, positive anti-retinal antibodies and negative work-up for cancer was diagnosed with npAIR. Visual acuity and ancillary tests were normal except abnormal ERG in both eyes. The patient was given one course of rituximab 375 mg/m2/week for 4 weeks and cyclophosphamide 1 gr/m2/month for 6 months. A second course of rituximab was necessary as autoantibody titers showed no change and as new antibodies were noted after treatment with rituximab and cyclophosphamide. Electroretinography was repeated after the first course of rituximab, after cyclophosphamide, and the second course of rituximab therapy.Conclusions and importanceRituximab therapy led to marked improvement in full-field ERG readings and regression of symptoms was reported by the patient after rituximab infusions. The effect of rituximab in npAIR was objectively demonstrated with ERG.

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Section: Introductionmentioning

confidence: 99%

Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy

Uludağ

Onal

Arf

et al. 2016

American Journal of Ophthalmology Case Reports

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“…7,8,10 Visual prognosis is generally good, especially after the era of advancement in chemotherapy. 8,12,16,17…”

Section: Discussionmentioning

confidence: 99%

“…Some mechanisms have been implicated in the pathogenesis of UHL that may include direct invasion of choroid and retina by lymphomatous cells, paraneoplastic syndromes, presence of antiretinal autoantibodies in the serum, a side effect of chemotherapy or a sequelae of immunosuppression. 10,14,16,18 HL may accompany other paraneoplastic syndromes such as cutaneous and central nervous system symptoms and signs, which can be the initial presentation. 19,20 Similarly, ocular structures with a predilection to the uveal tract can be uncommonly involved as part of this paraneoplastic inflammatory reaction before the diagnosis of HL.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous panuveitis associated with Hodgkin lymphoma: A case report with review of the literature

Alshamrani

Alsarhani

Aljasser

et al. 2020

European Journal of Ophthalmology

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Background: Intraocular lymphoma (IOL) is an uncommon ophthalmic malignancy and poses a diagnostic challenge. Uveitis associated with systemic lymphoma (USL) has been predominantly attributed to non-Hodgkin lymphoma (NHL) and rarely reported with Hodgkin lymphoma (HL) in the literature. Methods: Case report with review of the literature. Results: A 25-year-old healthy male presented with bilateral granulomatous panuveitis including vasculitis and discrete chorioretinal yellowish-white lesions. Macular optical coherence tomography (OCT) of both eyes revealed a disruption of ellipsoid and interdigitation zones over the areas of subretinal lesions as well as a small sub-retinal pigment epithelium (RPE) deposit in one eye. Thorough uveitis workup revealed clavicular, axillary and cervical lymphadenopathy, and biopsy of lymph nodes confirmed the diagnosis of nodular lymphocyte-predominant (NLP) HL. Six months later and after receiving chemotherapy, all symptoms and most of clinical signs resolved. Conclusions: Clinical features of USL do not differ between HL and NHL. However, the age of presentation may be much younger in HL. Ocular manifestations can precede systemic HL diagnosis, as shown in our patient. Therefore, USL should be part of the differential diagnosis of panuveitis. Paraneoplastic inflammation is thought be the cause of uveitis associated with HL. The sub-RPE deposit and disruption of ellipsoid and interdigitation zones on OCT have not been documented before as a manifestation of uveitis secondary to HL. In addition, the NLP subtype of HL was reported in only 1 case with uveitis in the literature.

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“…Sixteen cases had bilateral involvement with asymmetric inflammation between both eyes, while the remaining 5 cases were unilateral. Cotton wool spot-like or hypopigmented chorioretinal lesions have been described in 8 cases [21,[24][25][26][27][28]. In 4 patients with intraocular biopsies, either via fine-needle aspiration biopsy of an iris nodule, vitreous biopsy, enucleation, or via autopsy, ocular invasion by HL was not detected in any of the specimens.…”

Section: Uveamentioning

confidence: 99%

Ophthalmic Manifestations of Hodgkin Lymphoma: A Review

et al. 2021

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Background: Hodgkin lymphoma (HL) is a hematopoietic neoplasm characterized by cancerous Reed-Sternberg cells. In contrast to ophthalmic manifestations by non-HL that are well recognized, there is paucity of the literature as it relates to ophthalmic manifestation by HL. We performed a comprehensive review of published studies (case reports and small case series) to characterize the ophthalmic manifestations of HL. Summary: Thirty patients were identified with ophthalmic manifestation of HL. Thirteen (43%) were male, and 14 (46%) were female (in 3 cases, sex was not specified). The median age at ophthalmic presentation was 27 years. Diagnosis of HL was made after ophthalmic manifestation in 10 (33%) cases, whereas 11 (36%) cases had a prior diagnosis of HL. Ophthalmic manifestations can be classified into 3 main groups; direct infiltration, inflammatory reaction, and paraneoplastic process. Seven cases had infiltration of the optic nerve. Uveal inflammatory reaction was reported in 21 cases. The presence of intraocular Reed-Sternberg cells had been confirmed in 1 case with granulomatous uveitis. Conjunctival and corneal reaction was seen in 3 cases. HL was in stage 2 or higher, with only 1 case with stage 1A (12 cases HL stage not specified). Seven cases (22%) died of HD, all were diagnosed with advanced lymphoma, and none was treated with chemotherapy. Key Message: Ocular involvement in HL is extremely rare. A few cases of histopathologically confirmed optic nerve/tract infiltration are within the spectrum of CNS involvement by HL. Inflammatory uveitis is the most common ophthalmic association of HL. In the presence of prior known diagnosis of HL, restaging should be considered to exclude recurrence. Toxicity or adverse reaction to drugs used to treat HL may also contribute to ophthalmic involvement.

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Retinal Involvement in Uveitis Associated With Hodgkin Disease

Abstract: The presence of an antiretinal autoantibody, granulomatous uveitis, and retinal thinning in a patient with Hodgkin disease suggests that the patient had a granulomatous uveitis associated with Hodgkin disease or lymphoma-associated uveitis with retinal involvement.

Cited by 5 publications

References 12 publications

Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy

Electroretinographic improvement after rituximab therapy in a patient with autoimmune retinopathy

Granulomatous panuveitis associated with Hodgkin lymphoma: A case report with review of the literature

Ophthalmic Manifestations of Hodgkin Lymphoma: A Review

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