Centre of Ophthalmology University of Tuebingen, Germany

Slides:

Advertisements

Similar presentations

Mak KS, 1 Miller RC, 2 Krishnan S, 3 Laperriere N, 4 Micke O, 5 Rutten I, 6 Kadish SP, 7 Ozsahin M, 8 and Mirimanoff RO 8 1 Harvard Medical School, Boston,

Advertisements

Optic disk edema and macular serous retinal detachment as an early sign of Bartonella henselae systemic infection Dr. Carlos Alvarez-Guzmán 1 Dr. Alejandro.

Josephine-Liezl Cueto, M.D.* Kendall R. Dobbins, M.D.* Geisinger Medical Center, Department of Ophthalmology Danville, PA *No financial interest.

Combine conference NS 張維傑 / Chief CC Shen.

1 Slides Shown at FDA Advisory Committee Eyetech Pharmaceuticals Pfizer, Inc. Dermatologic and Ophthalmic Drugs Advisory Committee Meeting 27 August 2004.

Bilateral Endogenous Bacterial Endophthalmitis and Bacteraemia as the presenting manifestation of Multiple Myeloma. Peter Cikatricis Peter Cikatricis 1,

Uveitic Macular Edema Nihal Elshakankiry, MD, PhD Professor of Ophthalmology Rowayda M. Amin, MSc Assistant Lecturer of Ophthalmology Alexandria University.

Ocular Candidiasis Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Siderosis Bulbi Zamzam Al-baker,MD Consultant Opthalmology

Eales' disease Dr Chinmayi Vyas M.S. Dr Jyotirmay Biswas

Consultant, Uveitis Service

Aravind Eye Hospital, Madurai

Acute Retinal Pigment Epithelitis

Advanced Eye Centre and Department of Neurology*

Behcet's Disease in an Indian Patient

Consultant, Uveitis Service

Vogt Koyanagi-Harada Luca Cimino Luca Cappuccini

Cancer Associated Retinopathy

Assist. Lecturer of Ophthalmology

Chikungunya Retinitis

Neuroretinitis secondary to Bartonella henselae

Cat Scratch Disease Rupesh Agrawal, Carlos Pavesio

Bartonella Neuroretinitis

After Cataract Surgery…

Unusual anterior Uveitis in a Child. Ocular History  10 year old boy  1/2001: OD>OS  red eyes  iris thickening,  endothelial precipitates, hyphema.

Debra Goldstein, MD Northwestern University Chicago, IL

Ahmed Y. Hatata, MSc Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University, Egypt Toxocariasis.

Neuroretinitis Anna-Maria Gerlach, Werner Inhoffen Deshka Doycheva, Manfred Zierhut Centre of Ophthalmology University of Tuebigen Germany.

Combined CRVO & CRAO Mamta Agarwal Senior Consultant Uveitis & Cornea Services Sankara Nethralaya Chennai.

Intraocular Tuberculosis

Posner-Schlossman Syndrome Bianka Sobolewska, MD Manfred Zierhut, MD Centre of Ophthalmology University of Tuebingen, Germany.

Diffuse infiltrating retinoblastoma > >. Ocular and General History  5 years old boy  Unremarkable birth history (BBW: 2800g, full-term)  No preceding.

Uveitis-Glaucoma-Hyphema Syndrome Constanze Kortuem, Daniela Suesskind, Manfred Zierhut Centre for Ophthalmology University of Tuebingen, Germany.

Manfred Zierhut Centre of Ophthalmology University of Tuebingen, Germany Retinal Vasculitis.

MULTI-NODULAR POSTERIOR SCLERITIS Dr Nilutpal Borah, M.S. Guwahati Eye Institute and Research Center Assam, India.

ACUTE RETINAL NECROSIS

Whipple´s Disease Manfred Zierhut Centre of Ophthalmology

Persistent placoid Maculopathy TB related Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Panuveitis Mamta Agarwal Senior Consultant Uveitis & Cornea Services Sankara Nethralaya Chennai.

Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome Sana Khochtali Imen Ksiaa Anis Mahmoud Bechir Jelliti Department of Ophthalmology Fattouma Bourguiba.

Central serous chorioretinopathy and uveitis Central serous chorioretinopathy and uveitis Rim Kahloun, MD Sonia Zaouali, MD Moncef Khairallah, MD Moncef.

Behçet´s Disease Christoph Deuter Centre for Ophthalmology, University Hospital, Tuebingen, Germany.

Posterior Scleritis associated with Orbital Pseudotumor Nikolas London, MD Retina Consultants San Diego.

Manfred Zierhut Manfred Zierhut Centre of Ophthalmology University of Tuebingen, Germany Masquerade Syndrome.

Cryptococcus choroiditis

A CASE OF INFECTIOUS AND AUTOIMMUNE DISEASE COEXISTENCE Elisabetta Miserocchi MD Department of Ophthalmology and Visual Sciences University Hospital San.

Choroidal Tuberculoma Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Live intraocular worm causing multifocal choroiditis Dr Mamta Agarwal Dr J Biswas.

Acute choroidal ischemia and Toxoplasmic Retinochoroiditis Acute choroidal ischemia and Toxoplasmic Retinochoroiditis Sonia Attia, MD Imen Ksiaa, MD Moncef.

Endoscopic Management of Displaced IOL Causing Recurrent Hyphema in Patient With Pseudoexfoliation J. M. Rouse, M. A. Khaimi Dean McGee Eye Institute,

Sympathetic Ophthalmitis Annie Mathai, Rajeev K Reddy, Hemant S Trehan, Ritesh Narula Smt.Kanuri Santhamma Retina Vitreous Centre, Kallam Anji Reddy Campus,

Punctate Inner Choroidopathy Ahmed Magdy Bedda, MD, PhD Professor of Ophthalmology Rowayda M. Amin, MSc Assistant lecturer of Ophthalmology Alexandria.

Toxoplasmic Retinochoroiditis Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Primary Inflammatory Choriocapillaropathy Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.

Hypopyon Uveitis Linda Huang, MD Ronald Rescigno, MD Rutgers, New Jersey Medical School.

Cryptococcus neoformans Choroiditis Rupesh Agrawal, Ho Su Ling, Stephen Teoh Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore.

Acute Retinal Necrosis

Presumed tuberculosis-associated uveitis: rising incidence and widening diagnostic criteria in non-endemic area Nikolas Krassas1, Jane Wells1, Christine.

Posner-Schlossman Syndrome

Sympathetic Ophthalmitis

Consultant, Uveitis Service

Anterior Uveitis in a Child

Atypical case of Vogt- Koyanagi-Harada disease

Vogt-Koyanagi Harada Disease

Inflammatory choroidal neovascularization

National Institue of Infectious Diseases

Multiple evanescent white dot syndrome

February 2007 Note: Source:.

Neuroretinitis Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital,

Presentation transcript:

Centre of Ophthalmology University of Tuebingen, Germany Intraocular Lymphoma Manfred Zierhut Centre of Ophthalmology University of Tuebingen, Germany

Ocular History 46 year old woman 3-2000: OD blurred vision 1999: OS „similar problems“

April 2000: First Presentation VA: OD 20/20, OS 20/25 Mild AC cell infiltration Fundus: Multifocal chorioretinitis Pigment atrophy

April 2000: First Presentation ESR: 59/100 (known since 1995) Prednisolone 75 mg Improvement

June 2000 to February 2001 6-2000: Recurrence with retinal infiltration 8-2000: OD: CME: VA 20/32 Prednisolone: minimal improvement 9-2000: Optic disc edema with bleeding 11-2000: Azathioprine 150 mg 2-2001: inactive, VA 20/20

May 2001 Peripheral CNV with subretinal bleeding Serpiginous chorioretinitis?

July 2001 to August 2001 7-2001: Pigmentepithel detachment Exsudative retinal detachment MRI of the brain: negative Steroid induced diabetes 8-2001: Cyclosporine A: bleeding in resorption

September to October 2001 9-2001: OD: 20/100, OS: 20/32 Massive vitreous cells 10-2001: OD: 20/400 Diagnostic ppV: no lymphoma cells

Diagnosis after choroidal Biopsy B-cell non-Hodgkin lymphoma Positive for CD20, MIB1 Negative for CD3, CD138, c-kit, HMB45, κ-, and λ Bone marrow: negative

Problems Ocular disease with the highest 5-year letality Increasing incidence Diagnosis often late Negative vitreous biopsy does not exclude NHL Therapy not clear when CNS-manifestation is missing

Case Report: Treatment Intravenous Methotrexate 10-2001: 1. course (7.52 g) 11-2001: 2. and 3. course 12-2001: 4. and 5. course 1-2002: 6. course

Follow-up 11-2001: VA: 20/200, 20/40 Remaining bleedings Resorption of the infiltration Scarring 10-2007: No signs of recurrence or scarring VA: 20/200, 20/20

Final Diagnosis Non-Hodgkin lymphoma without CNS involvement Untypical clinical manifestation immitating Serpigninous Multifocal chorioretinitis With development of subretinal neovascularisation membrane Good response of the eye to i.v. MTX

Conclusion Clinic of intraocular lymphoma highly variable Can mimic multiple other uveitis disorders When diagnostic ppV negative but still suggestive for lymphoma: retinal biopsy In this patient i.v. MTX (3 g/m2) was effective as monotherapy