J Korean Ophthalmol Soc > Volume 58(12); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(12):1410-1415.
DOI: https://doi.org/10.3341/jkos.2017.58.12.1410    Published online December 15, 2017.
A Case of Mucosa-associated Lymphoid Tissue Lymphoma Discovered by Repetitive Intraocular Lens Dislocation.
Bo Ram Kim, Seonghee Choi, Yuri Seo, Tae Im Kim, Eung Kweon Kim, Jin Sook Yoon
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. yoonjs@yuhs.ac
반복되는 인공수정체이탈로 발견된 안와 점막연관림프조직 림프종 1예
김보람⋅최성희⋅서유리⋅김태임⋅김응권⋅윤진숙
연세대학교 의과대학 안과학교실 시기능연구소
Correspondence:  Jin Sook Yoon,
Email: yoonjs@yuhs.ac
Received: 14 September 2017   • Revised: 27 September 2017   • Accepted: 21 November 2017
Abstract
PURPOSE
To report a case where bilateral malignant retrobulbar lymphoma was diagnosed after repetitive intraocular lens dislocation to the anterior chamber. CASE SUMMARY: An 85-year-old male with a history of stroke who had undergone cataract surgery 10 years ago at another hospital presented with repeated intraocular lens (IOL) dislocations of both eyes into the anterior chamber. He had previously undergone IOL scleral fixation once in his left eye and twice in his right eye, but IOL dislocation was still repeatedly occurring. The best-corrected visual acuity was 0.4 in both eyes. Hertel exophthalmetry was 20 mm in his right eye and 18 mm in his left eye. Painless limitation of motion at supraduction was observed in the right eye. Funduscopy showed newly appeared choroidal folding in the right eye, so orbital computed tomography (CT) with contrast was performed. The CT scans showed bilateral homogenously enhancing retrobulbar masses. Biopsy of the masses showed a MALToma. After radiation therapy, the choroidal folds resolved and exophthalmetry improved to 10 mm in both eyes. No additional IOL dislocation occurred. During 2.5 years of follow-up, there was no evidence of recurrence or distant metastasis of the MALToma. CONCLUSIONS: Orbital lymphomas can cause lid edema, exophthalmos, strabismus, and diplopia, and can be diagnosed with imaging modalities such as CT. Final diagnosis involves biopsy and radiation therapy or chemotherapy. If IOL dislocation occurs repeatedly, it may result from an increase in retrobulbar pressure, and concurrent choroidal folding using funduscopy is strongly recommended for imaging to check for the presence of retrobulbar masses.
Key Words: Choroidal folds;Dislocation of intraocular lens;Retrobulbar mass;MALToma


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