TABLE 2.
OUTCOMES BEFORE AND AFTER CHORIORETINAL BIOPSY IN EIGHT PATIENTS WITH ATYPICAL PRESENTATIONS OF UVEITIS
| PATIENT | VA (PREBIOPSY) | DURATION OF FIRST SYMPTOMS BEFORE BIOPSY | DIAGNOSTIC VITRECTOMY RESULT (IF DONE PRIOR TO RETINAL BIOPSY) | RETINAL/CHOROIDAL BIOPSY RESULT | ENUCLEATION RESULT | DIAGNOSIS | FINAL VA | DURATION OF FOLLOW-UP |
|---|---|---|---|---|---|---|---|---|
| A | LP | 2 weeks | Negative cytology and flow cytometry; viral PCR and microbial cultures negative | Necrotic retina with destruction of normal retina, atypical lymphocytic infiltrate | N/A | Intraocular lymphoma; CNS lymphoma, diagnosed soon after | LP | 5 years |
| B | NLP OS
20/30 OD |
7 years | N/A | OS: Metaplastic changes in choroid and RPE with bone, fibrosis, and mild lymphocytic infiltrate. No retinal inflammatory infiltrate. Viral PCR and staining negative | N/A | Uveitis and subretinal fibrosis | NLP OS
20/20 OD |
9 years |
| C | NLP OD
LP OS |
56 weeks | N/A | OD: Granulomatous inflammation of the choroids and retina; staining for AFB, fungi negative, PCR for viruses and Toxoplasma negative | N/A | Sarcoid | NLP OU | 7 years |
| D | 20/25 | 94 weeks | Negative cytology and flow cytometry for malignancy | Dense choroidal infiltrate of lymphocytes and plasma cells. Immunophenotying: Monoclonal B-cell infiltrate consistent with low-grade B-cell lymphoma of MALT type with plasmacytic differentiation | N/A | Intraocular lymphoma | 20/70 | 25 months |
| E | 20/100 OS
20/30 OD |
20 weeks | Negative cytology and flow cytometry for malignancy; negative viral PCR | OS: Chronic inflammation with mild necrosis of retina with minimal inflammatory cell infiltrate, moderate lymphocyte and plasma cell infiltrate in choroid. Flow cytometry negative for malignancy | Diffuse infiltrate of atypical lymphocytes in the sub-RPE space. Flow and immunophenotyping positive | Diffuse large B-cell intraocular lymphoma | 20/50 OD
Prosthesis OS |
15 months |
| F | CF | 4 weeks | Negative cytology and flow cytometry for malignancy | Sub-RPE atypical lymphocytes positive CD20+ and Ki-67 immunohistology stains | N/A | Intraocular lymphoma | CF | 14 months |
| G | 20/50 | 1 week | N/A | Choroidal infiltrate of large atypical cells, cell marker studies confirm relapse of large cell lymphoma (CD 20 and CD 45 positive) | N/A | Intraocular lymphoma | 20/60 | 10 months |
| H | 20/80 | 18 weeks | Negative cytology and flow cytometry for malignancy | Choroidal lymphocytic infiltrate containing large cells with large atypical nuclei. | N/A | Intraocular lymphoma | 20/40–2 | 44 months |
AFB = acid-fast bacteria; CF = count fingers; CNS = central nervous system; LP = light perception; MALT = mucosa-associated lymphoid tissue; N/A = not applicable; NLP = no light perception; PCR = polymerase chain reaction; RPE = retinal pigment epithelium; VA = visual acuity.