Hodgkin Lymphoma Associated Retinopathy: Report of a Case.

PURPOSE: To report a case of Hodgkin lymphoma (HL) associated retinopathy. METHOD: Single-case, retrospective review of ophthalmological and systemic manifestations. RESULTS: A bilateral panuveitis in a 17-year-old Caucasian woman led to the diagnosis of HL. The ocular findings were characterized by anterior uveitis, vitritis, white chorioretinal lesions, papillitis and vasculitis. The diagnosis of nodular sclerosis stage IIA HL was confirmed by a cervical ganglion biopsy. Other causes of uveitis were excluded. The remission of HL was obtained by chemotherapy and the ocular lesions became quiescent, with pigmented chorioretinal scars, predominating along retinal vessels. Recurring visual symptoms one year later led to the diagnosis of the relapse of the HL. The remission of the HL was again obtained by a second line of chemotherapy while ocular symptoms subsided. CONCLUSIONS: Hodgkin lymphoma may be added to the list of diseases that can occasionally be revealed by ocular paraneoplastic syndromes.

Ophthalmic involvement of chronic lymphocytic leukemia: A systematic review of 123 cases.

To identify clinical presentations, main causes, and prognosis of ophthalmic involvement in chronic lymphocytic leukemia (CLL), we performed a systematic review of articles describing CLL ophthalmic involvement in January 2019, using the PubMed database. We found 86 articles describing 123 cases of patients with ophthalmic involvement associated with CLL. Ophthalmic symptoms were CLL's first manifestation in 25.6% of patients and revealed Richter transformation in 11.0%. There were three main causes of ophthalmic features: CLL-infiltration (52.0%), lymphoma (26.0%), and infection (15.4%), with specific clinical and radiological characteristics. CLL-infiltration was mostly bilateral, whereas lymphoma was usually unilateral (P = 0.02). Optic neuropathy was always secondary to CLL-infiltration, and in those cases, cerebrospinal fluid immunophenotyping was a potential alternative to invasive biopsy as it confirmed the diagnosis in 4 patients (36.4%). On the contrary, lymphoma usually presented as adnexal involvement (P = 0.04), particularly as an orbital mass (P = 0.004). Infections concerned mostly patients previously treated for CLL (P < 0.0001), and main presentations included posterior uveitis (P = 0.0002) and retinal infiltrates (P < 0.0001). Overall, the prognosis was poor, as 29.3% of the patients died within 36 months of follow-up, and 26.1% had a partial or total visual loss. Eye infections were associated with the poorest prognosis as 47% of patients died, with a 6-month-median survival.

Orbital disorder revealing a lung cancer: a case report.

INTRODUCTION: Orbital metastases are rare and they are even rarer to be the first sign of the disease, which can lead to misdiagnosis and delay of management. OBSERVATION: Our patient consulted for a diplopia and a ptosis of the upper eyelid of the right eye since one month, without any other systemic symptoms. After ophthalmological examination and orbital tomography, the diagnosis of orbital metastasis was suspected. Lung cancer was revealed by thoracic tomography and confirmed by an anatomopahological examination. CONCLUSION: Because of the increased incidence of neoplasia, the diagnosis of orbital metastasis should be considered in any elderly patient who consults for symptomatology related to orbital involvement.

Ophtalmoplegia complicating sino-orbital mucormycosis.

PURPOSE: To report a case of complete ophthalmoplegia and blindness in sino-orbital mucormycosis. CASE REPORT: A 68-year-old woman with history of diabetes and breast cancer presented with sudden onset of fever, orbital pain and blindness in the right eye. The patient was found to have no light perception, complete ophthalmoplegia, chemosis, corneal ulcer and optic nerve atrophy. In rhinologic examination, necrosis was noticed. Brain and orbit magnetic resonance imaging showed diffuse sinusitis with orbital involvement. The result of the clinical examination was reported as sino-orbitalmucormycosis. The diagnosis was confirmed by pathological specimens. The patient underwent extensive surgical debridement and systemic antifungal treatment. Despite treatment, visual acuity did not recover. CONCLUSION: The sino-orbital form of mucormycosis is a rare and insidious fungal infection. Ocular findings may range from orbital pain to ophtalmoplegia and blindness such as in our case. Black scar tissues seen on the nasal mucosa are pathognomonic. Delay in treatment due to late presentation and complications were major determinants in ocular prognosis and survival outcome.