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New research · Ophthalmology
American journal of ophthalmology case reports · 16h
Case reportAmerican journal of ophthalmology case reports · 2026

Rapidly progressive primary vitreoretinal lymphoma with optic disc involvement and retinal detachment.

Masahiro Akada, Yuki Muraoka, Kenji Ishihara … Akitaka Tsujikawa
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OphthalmologyCase report

Intravitreal methotrexate restored vision from light perception to 20/20 in vitreoretinal lymphoma

Rapidly progressive primary vitreoretinal lymphoma with optic disc involvement and retinal detachment.

Masahiro Akada … Akitaka Tsujikawa
American journal of ophthalmology case reports · 2026
Purpose

This report presents a diagnostically challenging and aggressive case of primary vitreoretinal lymphoma, demonstrating the potential for recovery following early diagnostic vitrectomy and prompt intravitreal methotrexate.

20/20
Results
20/20
eye's sharpness returned to normal after treatment, from only detecting light before
More results

OBSERVATIONS: A 42-year-old woman presented with a 1-week history of temporal visual field loss in the right eye and was referred to our hospital for suspected retinal detachment.

Fundus examination revealed vitreous cells, retinal hemorrhages, retinal vasculitis, and extensive subretinal fluid.

More results

Optical coherence tomography showed preretinal hyperreflective deposits with a level-like appearance.

Diagnostic vitrectomy identified a monoclonal B-cell population with an elevated interleukin-10/-6 ratio and clonality of the immunoglobulin heavy-chain gene, confirming primary vitreoretinal lymphoma.

“
Conclusion · 1 of 2

This case illustrates a fulminant presentation of primary vitreoretinal lymphoma, characterized by rapidly progressive optic disc involvement and extensive serous retinal detachment.

Conclusion · 2 of 2

Despite the severity, early diagnostic vitrectomy followed by prompt intravitreal methotrexate enabled anatomical and functional recovery.

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