PROGRESSION OF CHOROIDAL THICKNESS ON ENHANCED DEPTH IMAGING-OPTICAL COHERENCE TOMOGRAPHY AS THE FIRST SIGN OF ORBITAL LYMPHOMA.

Purpose: To present an orbital extranodal marginal zone B-cell lymphoma (mucosa-associated lymphoid tissue lymphoma) with increased choroidal thickness as the first diagnostic sign.

Methods: A patient presented with mild blurred vision in the left eye. Progressively increased choroidal thickness was demonstrated by enhanced depth imaging-optical coherence tomography and ocular ultrasound-confirmed diffuse choroidal effusion. Orbital MRI revealed a well-circumscribed intraconal orbital mass surrounding the optic nerve and molding around the globe. An orbital biopsy of the lesion with subsequent histologic and immunohistochemical analyses demonstrated mucosa-associated lymphoid tissue lymphoma.

Results: After initial treatment with rituximab without improvement, the patient received orbital radiotherapy (36 Gy in 20 sessions). A reduction in choroidal thickness was observed during follow-up visits. Congestion of the choroidal vasculature and choroidal infiltration by the lymphoma are discussed as possible causative mechanisms.

Conclusion: Enhanced depth imaging-optical coherence tomography can be a helpful tool to detect the presence of orbital lymphoid tumors in contact with the globe and to monitor response to therapy.