A case of Epstein-Barr virus-associated primary vitreoretinal lymphoma in an immunosuppressed patient

Retin Cases Brief Rep. 2023 Sep 23. doi: 10.1097/ICB.0000000000001500. Online ahead of print.

Abstract

Purpose: To describe a rare case of Epstein-Barr virus (EBV)-positive primary vitreoretinal lymphoma (PVRL) in an immunosuppressed patient.

Methods: Observational case report.

Results: A 64-year-old man under immunosuppressive therapy for rheumatic arthritis was referred for 2-month of blurred vision and decreased visual acuity in the right eye. Only mutton-fat keratic precipitates and mild vitreous opacity were found in the right eye without (sub-)retinal or sub-retinal pigment epithelial lesions. Vitreous biopsy and systemic workup suggested the diagnosis of PVRL of diffuse large B cell lymphoma (DLBCL) subform. Neoplastic cells stained positive for EBV antigens, EBV-encoded small RNA and Epstein-Barr nuclear antigen 2, consistent with EBV-positive DLBCL. Intravitreal methotrexate was effective in improving ocular symptoms.

Conclusion: Our case provided evidence on the association of EBV infection with PVRL.