A case of ocular diffuse large B-cell lymphoma unveiled through Pars Plana Vitrectomy: surgical insight and multidisciplinary management

TL;DR

A rare case of ocular lymphoma was diagnosed through surgery and required a multidisciplinary approach for treatment.

Contribution

Highlights the role of Pars Plana Vitrectomy in diagnosing ocular DLBCL and the need for personalized treatment strategies.

Findings

Pars Plana Vitrectomy confirmed DLBCL through cytogenetic analysis in an immunocompromised patient.

Initial intraocular rituximab treatment was followed by systemic progression requiring aggressive chemotherapy.

The case underscores the importance of early diagnosis and multidisciplinary management in ocular DLBCL.

Abstract

We present a rare case of ocular diffuse large B-cell lymphoma (DLBCL) unveiled through Pars Plana Vitrectomy in a 74-year-old immunocompromised male, highlighting the surgical insight and multidisciplinary management required for similar cases. The patient’s progressive vision impairment led to a Pars Plana Vitrectomy, which confirmed DLBCL through cytogenetic analysis. Initial intraocular rituximab treatment showed promise; however, the lymphoma’s systemic progression necessitated a shift to more aggressive chemotherapy, underscored by pleural and pericardial effusions and central nervous system involvement. This case emphasizes the critical role of surgical techniques in diagnosing ocular lymphomas and the importance of a multidisciplinary approach in managing the disease’s ocular and systemic manifestations. The complexities introduced by the patient’s immunosuppression highlight the necessity for individualized treatment strategies. This case calls for further research into ocular lymphomagenesis and exploring therapies with enhanced efficacy and reduced toxicity, and emphasizes the importance of early diagnosis in ocular DLBCL cases.

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