title: Multimodal Imaging of Spontaneously Shifting Primary Vitreoretinal Lymphoma.
abstract: OBJECTIVE
  To correlate spectral domain optical coherence tomography (SD-OCT) and photographic imaging before and after spontaneous regression of primary vitreoretinal lymphoma (PVRL) lesions.
  
  
  METHODS
  We report the case of a 60-year-old female.
  
  
  RESULTS
  The patient presented with bilateral creamy deposits under the retina and retinal pigment epithelium (RPE), and lesions were visible along Bruch's membrane with SD-OCT and suspicious for PVRL. Systemic workup revealed nonspecific areas of enhancement on neuroimaging. The patient was largely asymptomatic and the decision was made to observe her. Three months later, a new lesion pattern had developed. The color fundus photographs and SD-OCT demonstrated spontaneous regression of the largest sub-RPE lesion, leaving areas of RPE atrophy, while a new larger sub-RPE lesion had formed in the other eye. Vitreous biopsy showed lymphocytes and no malignant cells, while sub-RPE biopsy of the newly formed lesion revealed highly atypical cells positive for CD19 and CD20.
  
  
  CONCLUSIONS
  Multimodal imaging documents that PVRL lesion regression and early RPE changes can develop within a 3-month period. Immune control is an important factor in lesion regression in the eye.
authors.affiliation: Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Mantopoulos
authors.affiliation: Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Cebulla
keywords: Immune surveillance; Primary vitreoretinal lymphoma; Spectral domain optical coherence tomography; Spontaneous regression