Primary Vitreoretinal Lymphoma Masquerading as Refractory Uveitis—Just Go with the Flow

Primary vitreoretinal lymphoma (PVRL) is a rare and often misdiagnosed malignant neoplasm that can mimic other conditions like uveitis, leading to delays in diagnosis and treatment. This case study of a 59-year-old man highlights the diagnostic challenges of PVRL, which initially presented as intermediate uveitis. Despite initial treatment with corticosteroids, the condition relapsed, prompting further investigation through vitrectomy and flow cytometry, which confirmed the diagnosis of B-cell lymphoma. The patient underwent systemic chemotherapy, resulting in remission with no evidence of disease after 24 months. The study emphasizes the importance of early and accurate diagnosis to prevent CNS progression, which is a major cause of mortality in PVRL. Diagnostic techniques such as flow cytometry and vitrectomy are crucial, and treatment must be tailored to the individual, considering both local and systemic options to manage intraocular disease and prevent CNS relapse.