Abstract

A 45-year-old male presented with a headache and diminution of vision in RE. BCVA in RE- 6/18, LE- 6/6. IOP RE- 14, LE-16 mm Hg. The anterior segment was normal in BE. Fundus examination in RE- mild vitritis and drusenoid deposits at macula. LE fundus was WNL. OCT of RE showed hyperreflective spots at the level of RPE corresponding with the drusens. FFA RE showed punctate hyperfluorescent spots. ICG RE showed focal hyperfluorescent spots. In view of vitritis, uveitis profile was done which was WNL. A course of oral steroids was started at 1mg/kg body weight. After 1 month there was no improvement in patient symptoms. Then an MRI brain was ordered which showed a mass lesion in the right occipital lobe. The patient was referred to a neurosurgeon who did an excision biopsy. Histopathology revealed it to be an Occipital B cell lymphoma (high grade). Then a metastatic workup was done and the patient started on chemotherapy. Following the chemo his vision improved to 6/12.