Bilateral angle-closure glaucoma and multifocal choroiditis as a first presentation in hodgkin lymphoma.
OBJECTIVE
To report atypical ocular manifestations in two patients with undiagnosed Hodgkin lymphoma.


METHODS
Observational case report.


RESULTS
The first patient, a 27-year-old man, presented with bilateral acute angle-closure glaucoma secondary to uveal effusion. Histopathology of chest lymph nodes obtained by mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Ocular signs resolved after systemic chemotherapy. The second patient, a 56-year-old man, presented with bilateral multifocal choroiditis. Extensive biologic and microbiologic examinations were negative. Pathologic lymph nodes were detected in the anterior mediastinum. The histopathologic examination of the nodes after mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Systemic chemotherapy was instituted. The patient encountered a major increase in the multifocal choroiditis within 3 days after the second chemotherapy injection. High-dose intravenous corticosteroid therapy was initiated. No recurrence of choroidal lesions was observed after the treatment completion.


CONCLUSIONS
These two patients presented with bilateral paraneoplastic uveal tract involvement as initial presentation of Hodgkin lymphoma. Systemic corticosteroid therapy may be associated with systemic chemotherapy to obtain complete remission of the ocular inflammatory activity.
From the *Department of Ophthalmology, Saint Roch Hospital, Nice, France; Departments of †Ophthalmology, and ‡Internal Medicine, Edouard Herriot Hospital, Lyon, France; and §Department of Medical Oncology, Leon Berard Center, Lyon, France.
Stéphanie
S
Baillif
Pierre-Loïc
PL
Cornut
Charlotte
C
Girard
Hervé
H
Ghesquieres
Laurent
L
Perard