[세브란스안과병원의 EYE to EYE]
A 70-year-old female patient visited an ophthalmologist because her eyes suddenly appeared blurry and something seemed to float in her eyes. This patient was diagnosed with uveitis and received treatment for a while, but the condition did not improve. She had a stroke one day and went to the ER. He was diagnosed with brain lymphoma. Lymphoma invaded her eye. She has eye cancer.
People who often hear about cancer, which is the leading cause of death in Korea, such as stomach cancer, lung cancer and colorectal cancer, are a little puzzled when it comes to eye cancer. Probably because I’ve never heard of it. It is difficult to even find the word eye cancer in the national statistical index system, “e-Nara Index”.
Unfortunately, cancer can develop anywhere on the body, and the eyes are no exception. It can occur inside or outside the eye, but usually occurs inside the eye. Intraocular cancer is rare and often asymptomatic. It is difficult to distinguish it from another disease, so it is difficult to find a hospital late, which unfortunately leads to blindness and eye loss, or it can be life-threatening.
Lymphoma is a type of blood cancer, but it can rarely form in the eye. It occurs mainly in elderly or immunocompromised patients. This disease can develop into central nervous system lymphoma and become life-threatening. Therefore, periodic brain MRI should be checked.
Diagnosis is very complicated. It is similar to uveitis, an inflammatory disease, so it is often diagnosed as cancer late after treating it as simple inflammation. This is called “impostor syndrome.” It means wearing a ‘mask’ of simple irritation and hiding one’s true identity.
Uveitis usually occurs at a young age. If uveitis occurs in an elderly patient over 60 years of age, the possibility of intraocular lymphoma should be suspected. Lymphoma cells are weak and the amount of sample is small, making tissue diagnosis difficult. In 2020, Severance Eye Hospital presented the world’s first study that the diagnosis rate could be increased through full-length exome sequencing in vitreous samples from patients with intraocular lymphoma. Currently, the diagnosis rate has more than doubled with oncogene testing.
It is treated by injecting anticancer drugs into the eyeball or by performing radiation therapy. Intraocular lymphoma responds well to relatively weak radiation therapy, so there are fewer visual disturbances and side effects than with other cancers. If central nervous system involvement is present, chemotherapy and radiation therapy may be required, in which case the prognosis is poor.
