A case of intraocular malignant lymphoma presenting with atypical fundus lesions

Background: Intraocular malignant lymphoma is known to present with various findings that are also seen with uveitis-like lesions, such as subretinal infiltrates and vitreous opacity. We report a case of intraocular malignant lymphoma masquerading as uveitis that was finally identified by diagnostic vitrectomy. Case Report: A 60-year-old male presented with a history of blurred vision that progressed to loss of vision in his right eye. Subretinal atypical yellow-white lesions were seen around the posterior region, and a blood test for Toxoplasma antibody was positive. Two weeks after oral administration of acetylspiramycin, subretinal abnormal lesions disappeared. One year later, the abnormal lesions recurred with vitreous opacity in the left eye. Magnetic resonance imaging findings and diagnostic vitrectomy led to the diagnosis of intraocular malignant lymphoma with central nervous system lymphoma. Conclusions: It is difficult to arrive at a definitive diagnosis of intraocular malignant lymphoma because of the variety of clinical findings that may be present. Ophthalmologists should be careful to differentiate this condition from atypical uveitis in an early stage.