title: DIFFUSE LARGE B-CELL LYMPHOMA-ASSOCIATED-RETINOPATHY CHARACTERIZED BY MINIMAL MORPHOLOGIC CHANGES AND SEVERE FUNCTIONAL IMPAIRMENT.
abstract: OBJECTIVE
  To report the case of a patient whose retinal disease was found to be associated with a diffuse large B-cell lymphoma found 30 years after the apparent successful treatment of a classical Hodgkin lymphoma.
  
  
  METHODS
  Observational case report.
  
  
  RESULTS
  The authors describe the case of a 69-year-old man referred to their Department because of progressive, bilateral vision loss over the last few months. Deterioration in color vision and intense photophobia were also present. His best-corrected visual acuity was 20/400 in the right eye (RE) and 20/800 in the left eye (LE). Slit lamp and fundus examination failed to show any abnormalities. Spectral domain optical coherence tomography (SD-OCT) detected diffuse attenuation of the ellipsoid layers in addition to a focal subfoveal defect in both eyes. Both fluorescein and indocyanine angiographies (FA and ICGA) were normal. Full flash electroretinogram (ERG) revealed bilateral cone rod dysfunction with decreased amplitudes of both a and b waves.
  
  
  CONCLUSIONS
  Because of the late onset of the disease, poor visual acuity compared with a small macular anatomical lesion and a history of Hodgkin lymphoma 30 years ago, a neoplastic etiology was investigated. Poor performance status and chest pain led to a thoracic CT scan, which identified a massive mediastinal tumor. Serum analysis found an abnormal amount of antibody activity within the 40 kD region of Western blot of retina. The diagnosis of diffuse large B-cell lymphoma was established. Systemic examinations found a Stage IV non-Hodgkin lymphoma.
authors: *Department of Ophthalmology, Intercommunal hospital of Creteil, Creteil, France; †Department of Ocular Immunology, University of California, Davis, California; ‡Lymphoid Malignancies Unit, Henri Mondor Hospital, Creteil, France; and §Hematology Department, University Paris Est, Creteil, France.
authors: Laura
authors: L
authors: Moyal
authors: Olivia
authors: O
authors: Zambrowski
authors: Charles
authors: C
authors: Thirkill
authors: Caroline
authors: C
authors: Bottin
authors: Rocio
authors: R
authors: Blanco
authors: Corinne
authors: C
authors: Haioun
authors: Eric H
authors: EH
authors: Souied
mesh_terms: D000368:Aged; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000473:pathology; D059545:Paraneoplastic Syndromes, Ocular / Q000175:diagnosis*; D012164:Retinal Diseases / Q000175:diagnosis* / Q000473:pathology; D013997:Time Factors; D014786:Vision Disorders / Q000209:etiology*