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Maria E. Rivero, MD; Baruch D. Kuppermann, MD, PhD; Clayton A. Wiley, MD, PhD; Claudio R. Garcia, MD; Mark D. Smith, MD; Anna Dreilinger, MD; William R. Freeman, MD

Arch Ophthalmol. 1999;117:616-622.

Objective  To present the full clinical spectrum of the acquired immunodeficiency syndrome–related intraocular lymphoma as manifested in the eye, specifically retinal lymphoma associated with primary central nervous system lymphoma, isolated ocular lymphoma, and choroidal lymphoma associated with systemic lymphoma.

Methods  Three patients with acquired immunodeficiency syndrome were noted to have atypical retinal lesions. Diagnostic retinal biopsy in 2 patients and postmortem examination of the eyes in the third case were performed.

Results  Diagnostic retinal biopsy in the first 2 patients revealed retinal B-cell lymphoma. Initial systemic evaluation showed the eyes to be the sole site of disease. Later, in 1 of these patients, the lymphoma spread to the brain. The third patient developed an acute abdomen 4 months after the development of his ocular findings. The histological evaluation of the resected bowel revealed high-grade B-cell lymphoma. The patient died 1 week later and postmortem analysis of the eyes disclosed the presence of lymphoma in the choroid of both eyes.

Conclusions  This is the most complete series of patients with acquired immunodeficiency syndrome–related intraocular B-cell lymphoma and, to our knowledge, provides the first 2 cases diagnosed by retinal biopsy. These 3 cases present the full clinical spectrum of the disease as manifested in the eye.

From the Departments of Ophthalmology (Drs Rivero, Kupperman, Garcia, and Freeman) and Pathology (Dr Dreilinger), University of California at San Diego; and the Department of Pathology, University of Pittsburgh, Pittsburgh, Pa (Dr Wiley). Dr Kuppermann is currently with the Department of Ophthalmology, University of California, Irvine. Dr Smith is in private practice in San Diego, Calif.

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