Vitreoretinal Lymphoma: a clinical case highlighting the diagnostic and therapeutic challenge and the need for a multidisciplinary management

Vitreoretinal Lymphoma (VRL) is a rare ocular malignancy often presenting with atypical retinal findings, which can lead to misdiagnosis. We report the case of a patient with bilateral intraocular lesions and reduced visual acuity. Diagnosis was confirmed by multimodal imaging and molecular analysis of aqueous humor. Treatment consisted of intravitreal methotrexate and rituximab, followed by systemic chemotherapy, achieving partial resolution of the ocular lesions but subsequent ocular and systemic recurrence. After rescue treatment, patient achieved sustained complete remission. Early diagnosis and a multidisciplinary approach are essential, and multimodal imaging combined with molecular diagnostics is key in confirming the diagnosis.