Bilateral Central Retinal Vein Occlusion Secondary to Leukostasis in the Setting of Diffuse Large-B Cell Lymphoma: Case Report

Abstract

A woman in her 50’s was diagnosed diffuse large B-cell lymphoma (DLBCL) after presenting to hospital in a critical condition, characterised by marked hyperleukocytosis (white cell count 290 x10⁹/L). She subsequently developed painless blurred vision bilaterally, and was diagnosed with bilateral central retinal vein occlusion secondary to leukostasis. She was managed with non-Hodgkin lymphoma R-CHOEP14 (rituximab, cyclophosphamide, doxorubicin, vincristine, etoposide, prednisolone) immunochemotherapy, with her ocular signs and symptoms improving following treatment. Optical coherence tomography and funduscopic examination demonstrated no evidence of intraocular lymphoma. Visual acuity returned to 6/6 in each eye with subsequent resolution of her symptoms. Repeat examination demonstrated stable appearance of her ocular disease.

Keywords:

• hyperleukocytosis
• diffuse large-b cell lymphoma
• ophthalmology

Consent

The case report and its contents, including the results of investigations and images, was discussed with the patient, and informed consent for publication was obtained and documented in the hospital medical records system in June of 2022, prior to her death.

Institutional approval was not required.

Author Contributions

T.P.T and G.KG conceived the presented idea. T.P.T, A.C, M.B.L and G.KG carried out the patient examination and acquisition of data. A.C, M.B.L, G.KG contributed to the interpretation and analysis of the results. All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors have no financial, commercial or competing interests to disclose.