Case of primary intraocular lymphoproliferative disorder caused by Epstein-Barr Virus

• Published in: BMC ophthalmology Vol. 20; no. 1; p. 306
• Main Authors: Ban, Yumiko, Okamoto, Masahiro, Ogata, Nahoko
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.07.2020; BioMed Central; BMC
• Subjects: Acuity; Aged; Anterior chamber; Antibodies; Antigens; B cells; Blood; Case Report; Case reports; Corticosteroids; Epstein-Barr virus; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - diagnosis; Eye; Flow cytometry; Glucocorticoids; Health aspects; Herpesvirus 4, Human; Humans; Immunodeficiency; Infections; Inflammation; Lymphatic diseases; Lymphocytes; Lymphocytes B; Lymphoma; Lymphoproliferative disorder; Lymphoproliferative Disorders - diagnosis; Magnetic resonance imaging; Male; Masquerade syndrome; Mononucleosis; Patients; Polymerase chain reaction; Retina; Systemic diseases; Uveitis; Viruses; Vitrectomy; Vitreous Body; Flow cytometry; Lymphoproliferative disorder; Masquerade syndrome; Epstein–Barr virus; Uveitis
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-020-01583-x

Cases of panuveitis caused by Epstein-Barr virus (EBV) associated with primary intraocular lymphoproliferative disorder (LPD) are rare in immunocompetent individuals. A 67-year-old man noted blurred vision in both eyes and was referred to our hospital. His best-corrected visual acuity (BCVA) was 20/20 in both eyes. He had mild inflammation in the anterior chamber but not in the vitreous of both eyes. The inflammation was resolved with topical corticosteroid but 10 months later both eyes presented recurrence. Treatment with a sub-Tenon's injection of steroid was effective for OS but not for OD and 2 months after, the inflammation in the anterior chamber and vitreous opacities got worsen in OD and BCVA decreased to 6/20 OD. Thus, pars plana vitrectomy was performed on OD, and EBV was detected in the aqueous humor by multiplex polymerase chain reaction, and an infiltration of CD19κ positive B cells was revealed in the vitreous specimens by flow cytometry. Systemic workup revealed no other sites of lymphoproliferation, no active EBV infection, or underlying immunodeficiency. Panuveitis caused by EBV associated with primary intraocular LPD can occur in patients with no history of congenital or acquired immunodeficiencies.