Ocular Manifestations of Lymphoma

This prospective study sought to systematically evaluate the occurrence of ocular manifestations of lymphoma in newly diagnosed, treatment-naïve cats and to document ocular changes during chemotherapy. Cats with cytologically or histologically confirmed lymphoma diagnoses had opthalmic examinations performed on diagnosis and, if treated, repeated at follow-up appointments. Of the cats (n = 26), 12 had ocular changes; anterior or posterior uveitis was present in 58% of cats with ocular changes. Other lesions included corneal surface lesions, high-ablation retinae, iris swelling and redness, chemosis, and exophthalmos caused by retrobulbar mass effects. Of the 12 cats with ocular changes, 2 received chemotherapy. Complete remission of anterior and partial remission of posterior uveitis was noted in these cases. In 4 cases, ocular findings resulted in restaging from stage IV to V. Prognostic significance of the staging migration was not elucidated. The authors conclude that ophthalmic examination should be included in routine staging of cats with lymphoma, regardless of anatomic location or extent of disease.

Commentary

Ocular manifestations of lymphoma are poorly recognized in cats. This study suggests that almost 50% of cats may have ocular involvement. In reality, this incidence is likely lower. All cats with nasal lymphoma had ocular signs, which may have occurred secondary to trauma (eg, rubbing exophthalmic painful eye) or because of secondary growth of the nasal mass in the orbital space rather than lymphoma infiltration. FIV has been associated with uveitis, and not all cats were tested in this study. Finally, ocular changes were described but not further investigated, which suggests that other causes for these changes cannot be ruled out. Only 2 cats with ocular changes had follow-up ocular examinations postchemotherapy. This information would have been valuable in all cats with ocular changes.—Cecilia Robat, DVM, DACVIM (Oncology)