Vitritis and Outer Retinal Abnormalities in a Patient with COVID-19.

PURPOSE: To report a unique case of intraocular inflammation and outer retinal changes in a patient with coronavirus disease (COVID-19). CASE REPORT: A 57-year-old woman was seen 12 days after COVID-19 symptoms onset confirmed by positive IgM and IgG serological tests. No anterior chamber cells were seen. Color fundus photograph showed a yellowish lesion within the macular area, and fluorescein angiography revealed hyperfluorescence on the topography of the macular lesion in both eyes. Spectral-domain optical coherence tomography demonstrated hyperreflective pinpoints at the level of posterior vitreous hyaloid, corresponding to vitritis, hyperreflective lesions at the level of inner plexiform and ganglion cell layers, and disruption of the ellipsoid zone. CONCLUSION AND IMPORTANCE: COVID-19 is known to affect the inner retinal layers. The current case not only supports but also adds a vitreal and an outer retinal layer involvement that might also be caused by this infectious disease.

Bilateral Severe Vitritis, an intraocular recurrence of B cell lymphoma: a case report / Vitritis severa bilateral, una recurrencia intraocular de linfoma de células B: reporte de caso

Purpose: To report a case of bilateral vitritis originated from Primary Central Nervous System Lymphoma. Diagnosis was made from a careful history taking and confirmed with vitrectomy. Case report: 65-year-old Vietnamese male had one month of progressive blurred vision in both eyes without other eye complaint. History revealed that about one year previously, he was diagnosed with primary diffuse large B cell lymphoma. He was treated with chemotherapy of Methotrexate 3.5 g/m2and cytarabine 2 mg/m2, and a whole brain radiation therapy. There was a complete remission after the therapy. Fundus of both eyes was partly obscured by cells mainly in the posterior vitreous. Sequential bilateral vitrectomies were done on 5/1/17 and 7/17/17 without complication. The vitreous sample from the first eye having vitrectomy was sent for study which demonstrated large B cell lymphoma. Post-operative vision improved to 20/25 both eye without the complaint of hazy vision. Conclusion: Good history taking assisted in the diagnosis of intraocular lymphoma in this case with bilateral vitritis. However, bilateral vitrectomy restored the vision and further confirmed the diagnosis of lymphoma for future follow up care

Objetivo: Reportar un caso de vitritis bilateral originada por un Linfoma del Sistema Nervioso Central Primario. El diagnóstico se realizó a partir de una cuidadosa historia clínica y confirmada con vitrectomía. Reporte de caso: Varón vietnamita de 65 años con un mes de visión borrosa progresiva en ambos ojos sin otra afección ocular. La historia reveló que hace aproximadamente un año, se le diagnosticó un linfoma difuso primario de células B grandes. Fue tratado con quimioterapia con Methotrexate 3.5 g/m2 y citarabina 2 mg/m2 y una radioterapia cerebral completa. Hubo una remisión completa después de la terapia. El fondo de ambos ojos estaba parcialmente oscurecido por las células, principalmente en el vítreo posterior. Las vitrectomías bilaterales secuenciales se realizaron el 5/1/17 y el 17/7/17 sin complicaciones. La muestra vítrea del primer ojo sometida a vitrectomía fue enviada a un estudio que demostró linfoma de células B grandes. La visión postoperatoria mejoró a 20/25 ambos ojos sin la queja de la visión borrosa. Conclusión: una buena historia clínica fue útil en el diagnóstico de linfoma intraocular en este caso con vitritis bilateral. Sin embargo, la vitrectomía bilateral restauró la visión y confirmó aún más el diagnóstico de linfoma para el cuidado de seguimiento futuro.