[Vitrectomy in oculocerebral non-Hodgkin's lymphoma].

Ocular non-Hodgkin lymphoma (NHL) is thought to be a rare intraocular tumor; the clinical diagnosis, however, is difficult, and ocular NHL might occur more frequently than we thought. Vitrectomy is essential for establishing the diagnosis. During the last 6 years, we performed vitrectomies for ocular NHL in seven eyes of four patients. We report on the visual outcome and cytological findings. In three patients, we suspected the oculocerebral form of the disease; one patient suffered from a systemic lymphoma. The mean observation time was 19 months (5-30 months). In one patient, we failed to examine the vitreous fluid; this patient has since died. The other three patients underwent radiation treatment and/or chemotherapy; they are alive, and no recurrence of the NHL has since occurred. In all five cases in which cytological examination of the vitreous fluid was performed, we were able to establish the diagnosis of NHL on the first attempt. This accuracy is due to rapid and careful processing by the cytologist. Vision improved considerably in most cases. In only one eye with heavy retinal infiltration could vision not be restored. Secondary cataract extraction was necessary in five cases; otherwise, vision remained stable. We conclude that vitrectomy has to be done early in atypical vitreous "inflammations". Immediate processing and cytological examination of the vitreous fluid establishes the diagnosis of NHL and permits accurate radiation or chemotherapy. Early vitrectomy is greatly beneficial not only for visual rehabilitation but maybe even for a longer life expectancy.