2 TYPES OF INITIAL OCULAR MANIFESTATIONS IN INTRAOCULAR CENTRAL-NERVOUS-SYSTEM LYMPHOMA

Purpose: To study initial ocular manifestations of ocular-central nerv ous system (CNS) lymphoma. Methods: The authors reviewed medical recor ds of 10 consecutive patients with intraocular-CNS lymphoma seen at Ok ayama University Hospital during 10 years from 1981 to 1996, Results: Three patients showed only vitreous opacity as an initial sign, wherea s five other patients had typical yellowish-white infiltrates at the s ub-retinal pigment epithelial (sub-RPE) level without vitreous opacity . Both manifestations were found in two patients. In seven patients, o cular symptoms developed first, followed by brain lesions. In contrast , in three patients the initial presentation was brain tumor, for whic h they received chemotherapy; subsequently, vitreous opacity without s ub-RPE infiltrates developed. The diagnosis was made by vitrectomy in four patients, three of whom had also undergone brain biopsy; by aqueo us tap in one; and by brain biopsy in one. The other four patients wer e diagnosed clinically, and one of them was confirmed later to have ly mphoma by autopsy. Conclusions: The initial ocular manifestations of i ntraocular-CNS lymphoma were of two types, sub-RPE infiltrates and vit reous opacity. Keeping these two manifestations in mind will help phys icians consider a diagnosis of intraocular-CNS lymphoma earlier.