Development of Epstein–barr Virus Uveitis After Remission of Primary Vitreoretinal Lymphoma

Abstract

Purpose: To describe a case of Epstein-Barr virus (EBV) uveitis that occurred after the treatment and remission of primary vitreoretinal lymphoma (PVRL).Methods: Descriptive case report. Complete ophthalmologic evaluation, cytology, polymerase chain reaction, cytokine analysis of aqueous humor, and diagnostic vitrectomy were performed.Results: A 66-year-old Caucasian woman developed uveitis in the same eye 20 months after remission of PVRL. Empiric chemotherapy failed to treat the suspected PVRL recurrence, and aqueous humor cytology showed an absence of malignant cells. Qualitative polymerase chain reaction of aqueous humor confirmed the presence of EBV. Treatment for EBV resulted in remission of the uveitis.

Anterior segment involvement in Epstein–Barr virus: a review

“…Conversely, Chahal et al. (2016) described a case of a patient suffering from AAU 20 months after PVRL remission that was treated with topical steroid treatment and highlighted the importance of considering EBV in cases of suspected recurrence of PVRL with ineffective chemotherapy treatment. Moreover, recent studies suggest that patients with uveitis and high intraocular levels of EBV DNA or anti‐EBV antibodies appear to be at increased risk for HIV infection, including several patients with PVRL (Cunningham & Zierhut 2020).…”

“…Acute anterior uveitis (AAU) has been reported in a case series of EBV infections. Unlike AAU caused by other herpes viruses, EBV usually is neither hypertensive nor granulomatous (Morishima et al 1996;Chahal et al 2016;Ban et al 2020). Cigni et al (2003), Grefer et al (1999) reported a case of a middle-aged women with anterior uveitis associated with tubulointerstitial nephritis (TINU) after EBV infection.…”