Hit and Run: Bilateral Massive Intraocular Lymphomatous Infiltration after CAR-T Therapy.

PURPOSE: We report a case of bilateral intraocular infiltration of DLBCL after CAR-T therapy.

METHODS: Retrospective case report.

RESULTS: A 62-year-old Caucasian male with medical history of high-grade DLBCL presented with papillitis and vitritis upon completion of CAR-T therapy. Thorough infectious and diagnostic work-ups were performed. Diagnostic vitreous tap revealed intraocular lymphoma. The patient received external beam radiotherapy to both orbits with dramatic improvement in disc edema and vitritis. However, subsequent MRI showed development of intracranial metastatic disease, and the patient died within the same month.

CONCLUSION: Atypical intraocular metastasis of DLBCL may occur following CAR-T therapy and may indicate secondary changes in immunosurveillance within immune-privileged sites such as the eye.