Br J Ophthalmol 2001;85:93-95
( January )
Scientific correspondence
Chorioretinal post-transplant lymphoproliferative disorder
induced by the Epstein-Barr virus
P F Demolsa, P M Cochauxb, T Velub, L Caspers-Veluc
a Department
of Ophthalmology, Erasme University Hospital, Université Libre de
Bruxelles, Brussels, Belgium, b Department of Medical Genetics, Erasme
University Hospital, Université Libre de Bruxelles, Brussels, Belgium, c Department of
Ophthalmology, St Pierre and Brugmann University Hospitals
Correspondence to: Dr P F Demols, Department
of Ophthalmology, Erasme Hospital, 808 Route de Lennik, 1070 Brussels,
Belgium
paul.demols{at}euronet.be
Accepted for publication 27 June 2000
BACKGROUND
The
Epstein-Barr virus (EBV) is responsible for the lymphoproliferative
disorders observed in transplanted patients.
METHODSThe case
history is described of a 59 year old man with a chorioretinal lesion
who had received a single lung transplant and was on immunosuppressive
treatment. Immunoglobulin gene rearrangement and EBV detection by
polymerase chain reaction (PCR) with semiquantification were used on
the vitreous material.
RESULTSA
proliferation of B lymphocytes with a monoclonal subpopulation was
found by PCR on the vitreous sample. The large amounts of EBV genomes
found in the vitreous suggest that EBV was the cause of the
lymphoproliferation. Healing of the lesion was achieved by a decrease
in immunosuppressive treatment and the use of nucleotide analogues.
CONCLUSIONThe
diagnosis of ocular post-transplant lymphoproliferative disorder (PTLD)
can be made by PCR on vitreous material. Early diagnosis and treatment
can lead to regression of limited monoclonal lesions.
© 2001 by British Journal of Ophthalmology
