Ocular Involvement in a Patient with Intravascular Large B-Cell Lymphoma: A Diagnostic Challenge. Clinical Case Report and Literature Review.

PURPOSE: To describe the ophthalmic findings and diagnosis of a case of intravascular large B-cell lymphoma. METHODS: Clinical case observational report. CLINICAL CASE: A Spanish 51-year-old man referred to our hospital with a diagnosis of panuveitis. The patient presented with blurred vision, photophobia, fever, and weight loss. Ocular examination revealed anterior uveitis, vitritis, and multiple round and oval creamy spots on the posterior pole. Fluorescein angiography, optical coherence tomography (OCT), and angio-OCT were used for the ocular examination. The diagnosis of lymphoma was formulated on the basis of a random normal skin biopsy, which showed significant CD20 cellularity within the vessels and extensive CD3 expression. CONCLUSIONS: Intravascular lymphoma is a rare form of extranodal diffuse large B-cell lymphoma, often with delayed diagnosis because of the nonspecific symptoms. Hence, random skin biopsy could be useful in the diagnosis.

Clinical Manifestations and Treatment of Vogt-Koyanagi-Harada Disease during Pregnancy and after Birth: A Case Report.

PURPOSE: To describe the clinical manifestations of Vogt-Koyanagi-Harada (VKH) disease during pregnancy and after birth and the therapeutic challenge of treating patients with this condition. METHODS: We describe the clinical manifestations of this disease, as well as the diagnostic tests and treatments performed. RESULTS: The patient was referred for evaluation due to a persistent headache. Examination revealed bilateral anterior uveitis, papillitis and yellowish-white choroidal lesions in both eyes. A tentative diagnosis of VKH disease was made. A multimodal imaging study was performed at the time of presentation and throughout the disease course. The patient was initially treated with intravenous corticosteroids, and subsequently, oral corticosteroids and cyclosporine were administered. Clinical manifestations increased in severity after childbirth. CONCLUSIONS: The clinical course of VKH disease can be modified by pregnancy. While clinical manifestations during gestation may be mild, these may be exacerbated after birth. Treatment with corticosteroids and cyclosporine can be effective.