DIAGNOSTIC VITRECTOMY IN VITRITIS SECONDARY TO MYCOSIS FUNGOIDES RECURRENCE Dra. María Paz Mendívil Soto (Oftalmología, Sección Retina) Dra. Idoia Bearán María (Oftalmología, Sección Retina) Dra. Estibaliz Ispizua-Mendívil (Oftalmología, MIR2 ) Dr. Juan Carlos López Duque (Anatomía Patológica) Dra. Paloma Isusi Gorbea (Hematología - Citodiagnóstico) Hospital de Basurto, Bilbao Urg 27 sept

DIAGNOSTIC VITRECTOMY IN VITRITIS SECONDARY TO MYCOSIS FUNGOIDES RECURRENCE 67-year-old woman with a history of mycosis fungoides Progressive unilateral vitritis in her right eye. Clinical findings in the left eye were unremarkable, but mild vitritis was detected on OCT. One week later vision in the right eye had further deteriorated, visual acuity was 20/200. Right eye Left eye

DIAGNOSTIC VITRECTOMY IN VITRITIS SECONDARY TO MYCOSIS FUNGOIDES RECURRENCE Diagnostic pars plana vitrectomy was performed to obtain a sample of undilute vitreous from the right eye Vitrectomy was incomplete due to the severe vitreous haze, which made impossible any visualization of the fundus Sub-Tenon's triamcinolone  was injected before the end of the surgery 26 oct 2ª uveitis IQ VPP diagnostica, 10 oct

Talk to the pathologist DIAGNOSTIC VITRECTOMY IN VITRITIS SECONDARY TO MYCOSIS FUNGOIDES RECURRENCE Microscopic examination of the vitreous fluid (vitreous cassette): revealed a monomorphic population of atypical medium-sized lymphoid cells, kidney-shaped nuclear contours. prompt delivery appropriate media Handling of the sample correct temperature Flow cytometry (undiluted vitreous): abnormal immunophenotype of T lymphocytes, which in nearly 80% lacking CD3 and CD7 expression, and CD4 present, being this consistent with mycosis fungoides. Talk to the pathologist about the suspected diagnosis and desired testing necessary to increase the likelihood of a diagnosis

Ciliar injection improved, 1 millimeter hypopion DIAGNOSTIC VITRECTOMY IN VITRITIS SECONDARY TO MYCOSIS FUNGOIDES RECURRENCE The patient’s dermatologist and hematologist were contacted. Evening-fever for some days  urgent cerebral CT-scan Hospitalized 2 weeks later due to daily evening-fever No evidence of intracranial involvement Treatment: Dexamethasone drops General treatment was palliative due to the lack of response to previous chemotherapy and radiotherapy, and was limited to oral prednisone to control fever. Ciliar injection improved, 1 millimeter hypopion Any questions? Email me at: eispizua@gmail.com (Estibaliz Ispizua-Mendivil)