Utility of enface optical coherence tomography in intraocular lymphoma

PURPOSE To report the enface optical coherence tomography (OCT) features of intraocular lymphoma. METHODS Retrospective, observational case reportCase description A 59-year-old man, a known case of primary testicular carcinoma complained of right eye blurred vision since 1-week. He had undergone systemic intravenous chemotherapy (R-CHOP regime), orchiectomy and external beam radiotherapy for the primary malignancy previously. His right eye vision was 20/30, 6/6 RS. The right eye anterior segment examination was normal. Fundus examination showed vitreous cells 1+ and a large, bumpy, sub retinal dull-yellow lesion sparing the fovea with multiple discrete yellow retinal lesions at the posterior pole. Magnetic resonance imaging of the brain was normal. Multimodal imaging was used to document the clinical features. On the enface OCT, multiple hyperreflective lesions were identified on the superficial, deep and outer retinal slabs of the scan corresponding to the vertical hyperreflective lesions extending from the retinal nerve fibre layer to the RPE. The sub-RPE lesion can be well-delineated in the choriocapillaris segment. He was treated with multiple injections of intravitreal Methotrexate 400µg/0.1ml along with systemic chemotherapy in conjunction with the oncologist. At 6-months follow-up, fundus lesions had regressed. In addition, resolution of the lesions was noted on the OCT and enface OCT scans. CONCLUSION Enface OCT imaging can be considered for monitoring the therapeutic efficacy following intravitreal chemotherapy in intraocular lymphoma.