INDOLENT, NONPROGRESSIVE, MULTIFOCAL CHOROIDAL LESIONS: A Presumed Benign Choroidal Lymphoid Disease. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: Carroll, William J.; Deak, Gabor; J. Daily, Mark; Cunha de Souza, Eduardo; Shelsta, Heather N.; Barbante Casella, Antonio Marcelo; Jampol, Lee M.
• Is Part Of: Retina. Volume 40:Issue 10(2020)
• Publication Date: 2020-10
• Subjects: choroidal lesions -- choroidal lymphoid disease -- choroidal lymphoma -- reactive lymphoid hyperplasia; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002865
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: In 2012, four patients with multiple asymptomatic, indolent, unilateral, choroidal lesions were described. We suspected benign-behaving lymphocytes infiltrating the choroid. This article expands the number of patients and duration of follow-up and speculates further on the etiology. Although histopathologic confirmation of these lesions is still unknown, the natural course of these patients is excellent and should be distinguished from aggressive choroidal lymphoma. Methods: To qualify for the study, the patients had to meet the following criteria: 1) Patients collected had asymptomatic choroidal infiltrates as demonstrated in the figures; 2) absence of vitreous cells; 3) no evidence of concomitant systemic malignancy; 4) no systemic inflammatory diseases, including sarcoidosis; 5) no birdshot chorioretinopathy; 6) no conjunctival or orbital lesions; and 7) advanced multimodal imaging and clinical follow-up were performed. Results: There were 11 eyes of 11 patients seen. Follow-up ranged from 4 months to 12 years and 1 month (mean 50.2 months; median 24 months). Systemic workup was unrevealing. No patients in this cohort developed systemic, conjunctival, orbital, or vitreoretinal lymphoma or inflammatory disease. No patients developed symptoms or vision loss. Conclusion: This entity is an indolent choroidal infiltrative disease. It resembles some cases of choroidal lymphoma and may represent an indolent lymphocytic infiltrate. Abstract : The authors describe 11 eyes of 11 patients with asymptomatic, unilateral, flat, or slightly elevated choroidal lesions. Workup showed no systemic disease or involvement of the retina, vitreous, conjunctiva, or orbit. No effect on vision or spread outside the choroid was noted. Cases were followed without treatment and had no adverse outcomes.