Diagnostic Vitrectomy (25-Gauge) in a Case with Intraocular Lymphoma Masquerading as Bilateral Granulomatous Panuveitis

Abstract

Purpose. To report a case of intraocular lymphoma, masquerading as bilateral granulomatous panuveitis, and diagnosed after harvesting vitreous specimen with a 25-gauge vitrectomy instrument. Methods. A 67-year-old woman presented with bilateral granulomatous uveitis. Visual acuity in both eyes was severely impaired because of severe concurrent cataract and vitreous organization. Sutureless phacoemulsification and posterior chamber intraocular lens implantation combined with 25-gauge diagnostic vitrectomy was performed. Results. Cytopathology and immunocytochemistry of the vitreous disclosed a non-Hodgkin B-cell lymphoma despite unremarkable brain MRI, lumbar puncture, bone marrow aspiration, and whole body scan. Visual acuity improved to 20/120 in both eyes. Conclusions. Sutureless combined 25-gauge diagnostic vitrectomy, phacoemulsification, and posterior chamber intraocular lens implantation during one-stage surgery was effective in obtaining appropriate vitreous material for cytology in a case of intraocular lymphoma.