title: Two types of initial ocular manifestations in intraocular-central nervous system lymphoma.
abstract: OBJECTIVE
  To study initial ocular manifestations of ocular-central nervous system (CNS) lymphoma.
  
  
  METHODS
  The authors reviewed medical records of 10 consecutive patients with intraocular-CNS lymphoma seen at Okayama University Hospital during 16 years from 1981 to 1996.
  
  
  RESULTS
  Three patients showed only vitreous opacity as an initial sign, whereas five other patients had typical yellowish-white infiltrates at the sub-retinal pigment epithelial (sub-RPE) level without vitreous opacity. Both manifestations were found in two patients. In seven patients, ocular symptoms developed first, followed by brain lesions. In contrast, in three patients the initial presentation was brain tumor, for which they received chemotherapy; subsequently, vitreous opacity without sub-RPE infiltrates developed. The diagnosis was made by vitrectomy in four patients, three of whom had also undergone brain biopsy; by aqueous tap in one; and by brain biopsy in one. The other four patients were diagnosed clinically, and one of them was confirmed later to have lymphoma by autopsy.
  
  
  CONCLUSIONS
  The initial ocular manifestations of intraocular-CNS lymphoma were of two types, sub-RPE infiltrates and vitreous opacity. Keeping these two manifestations in mind will help physicians consider a diagnosis of intraocular-CNS lymphoma earlier.
authors.affiliation: Department of Ophthalmology, Okayama University Medical School, Okayama City, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsuo
authors.forename: A
authors.initials: A
authors.lastname: Yamaoka
authors.forename: F
authors.initials: F
authors.lastname: Shiraga
authors.forename: N
authors.initials: N
authors.lastname: Matsuo
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis*; D003131:Combined Modality Therapy; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology*