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Intraocular and Central Nervous System Involvement

John L. Keltner, MD; Esther Fritsch, MD; Robert C. Cykiert, MD; Daniel M. Albert, MD

Arch Ophthalmol. 1977;95(4):645-650.

Abstract
• A 58-year-old man with mycosis fungoides was treated with chemotherapeutic agents and radiation for the recurrent cutaneous form of this disease. Five years after the onset, he developed blurring of vision, neurologic signs, and then lapsed into coma. Chemotherapy and radiation treatment resulted in improvement of the ocular and systemic picture. Within three months, however, the patient's vision deteriorated and swelling of both optic discs, along with retinal and vitreous infiltrates, was noted. Local radiation of the eyes was followed by improvement of the ocular changes. Five months later the patient died. Results of a histologic examination of the eyes showed extensive involvement of the retina and vitreous by tumor cells. The CNS was remarkably free of tumor cells and it was assumed that the radiation and chemotherapy were responsible for this.

(Arch Ophthalmol 95:645-650, 1977)

Author Affiliations
From the Departments of Ophthalmology, Neurology, and Neurological Surgery, University of California School of Medicine, Davis (Dr Keltner), the Department of Ophthalmology, Harvard Medical School, and the Massachusetts Eye and Ear Infirmary, Boston (Dr Albert), and the Departments of Ophthalmology and Visual Science (Dr Fritsch) and Internal Medicine (Dr Cykiert), Yale University School of Medicine, New Haven, Conn.

Footnotes
Accepted for publication Oct 18, 1976.

Read before the Joint Verhoeff Society-European Ophthalmic Pathology Society Meeting, Washington, DC, April 26, 1976.

Reprint requests to Department of Ophthalmology, University of California School of Medicine, Davis, USD Professional Building, Room 251, 4301 X St, Sacramento, CA 95817 (Dr Keltner).

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