Transient Bacillary Layer Detachment During the Disease Course of Primary Vitreoretinal Lymphoma

• Published in: Ocular immunology and inflammation 2024-06, p.1-6
• Main Authors: Casalino, Giuseppe, Malerba, Alessia, Fabris, Sonia, Bolli, Niccolò, Croci, Giorgio Alberto, Pellegrini, Marco, Rossi, Francesca Gaia, Mapelli, Chiara, Viola, Francesco
• Format: Article
• Language: English
• ISSN: 0927-3948; 1744-5078
• DOI: 10.1080/09273948.2024.2359627

To report the clinical course and the retinal imaging features of a case of cytology-proven primary vitreoretinal lymphoma (PVRL) presenting with a transient bacillary layer detachment (BALAD) during the disease course. Observational case report. A 50 year-old woman was referred to us with a 2-month history of vitritis in both eyes, poorly responding to oral prednisolone. After discontinuation of oral prednisolone, worsening of vitritis and the appearance of multiple creamy-like subretinal infiltrates in the mid-peripheral retina of both eyes, along with the exclusion of common causes of intermediate/posterior uveitis, made us consider PVRL. Aqueous humor sampling detected L265P mutation, and subsequent diagnostic pars plana vitrectomy in the left eye yielded a positive cytology for large B cell lymphoma consistent with PVRL. During the disease course, optical coherence tomography of the macula showed a BALAD in the right eye, which resolved during follow-up. Our case indicates that BALAD is a possible rare manifestation of PVRL, and this should be considered in the differential diagnosis process in order to avoid diagnostic delays.