Author:Balaji Prasad Thalanki Shankarnarayan, MD

48 year old Caucasian man presented to eye casualty  November 2016, with recurrent Vitreous hemorrhages. The vision dropped from 6/12 to HM left eye. Patient had just finished the treatment for Chronic cough secondary to  Sarcoidosis/Tuberulosis and just finished.

Anterior segment normal in both eyes and right fundus was normal. Left fundus showed acute vitreous haemorrhage with hazy view of retina.  Retina showed multiple yellow patches.  Based on the ocular picture patient was referred to Haematologist to investigate for Lymphoma,. He was diagnosed as Diffuse B cell Lymphoma.

OCT imaging was difficult to obtain in view of the vitreous haemorrhage. The images in left eye showed multiple area of retinal undulations in posterior pole,  showing retinal thickening, inner and outer retinal hyperrelectivity. In addition choroidal deposits were identified, showing choroidal shadowing.

Patient also developed vitreous haemorrhage and subretinal deposits in right eye during his 6 months stay in hospital. He also developed disc pallor during the course of the disease in both eyes.

The patient was followed up during the course of intensive treatment for his Leukaemia, which improved his systemic condition. The OCT findings were followed longitudinally showing loss of hyperreflectivity in the retinal and RPE layers and resolution of Choroidal deposits . Following resolution of lymphomatous deposits the retina both eyes shows pigment changes and left eye showed macular scarring and macular hole.

As far as our knowledge this is first patient with Choroidal infilteration in addition to retinal Lymphomatous deposits which resolved after the treatment. Our case has a longitudinal OCT findings throughout the course.