Ocular Involvement as First Sign of Recurrence of Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma (MEITL).

PURPOSE: To report a case of ocular involvement as first sign of recurrence of MEITL.

METHODS

Single patient case report.

RESULTS

We report here the case of ocular involvement in MEITL that presenting as granulomatous anterior uveitis and vitritis, occurring 2 years after the initial diagnosis and successful systemic treatment. Diagnostic vitrectomy confirmed intraocular recurrence. The patient was treated with intravitreal methotrexate and oral temozolomide, which led to decrease inflammation and improvement of visual acuity after 4 weeks. Unfortunately, intravitreal injections had to be discontinued due to corneal toxicity. Shortly thereafter, the patient developed central nervous system progression and died from the disease despite treatment with intravenous methotrexate, procarbazine, and vincristine.

CONCLUSION

This case demonstrates the possibility of delayed and isolated intraocular relapse in MEITL. It highlights the risk of central nervous system involvement despite isolated ocular involvement and the need for systemic treatment despite local control with intravitreal Methotrexate.