Systemic Hodgkin Lymphoma with Presumed Intraocular Involvement

Purpose: We report a rare case of systemic Hodgkin lymphoma with presumed intraocular involvement that resolved following systemic chemotherapy. Method: Observational case report. Results: A 32-year-old woman with known stage II Hodgkin lymphoma presented with 3 months of photopsia and decreased vision in the left eye. Fundus examination demonstrated vitreous cells, more than 100 yellow choroidal infiltrates involving the entire fundus, and retinal pigment epithelial defects in the macular region of the left eye. Ultrasonography showed chorioretinal thickening and optical coherence tomography demonstrated vitreous opacities with outer retinal atrophy, irregular retinal pigment epithelial thickening, and hyper-transmission defects. A diagnosis of Hodgkin lymphoma with vitreoretinal involvement was considered. Fine needle aspiration biopsy was considered, but the patient preferred deferral as she was already on cycle 3 of systemic chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine). Following the fourth cycle of systemic treatment, the vitreous cells and choroidal lesions resolved. Conclusion: This case details a rare presentation of systemic Hodgkin lymphoma with presumed vitreoretinal and choroidal involvement that responded to anti-Hodgkin lymphoma chemotherapy.