Masquerade syndromes are uncommon conditions of either non-neoplastic or neoplastic origin that mimic uveitis with the presence of intraocular cells that are not thought to be due to immune-mediated mechanisms.
This Focal Points issue focuses on neoplastic masquerade syndromes, as these potentially life-threatening syndromes account for nearly half of all masquerade syndromes seen in tertiary referral centers. Intraocular involvement from primary central nervous system lymphoma is by far the most common of the neoplastic masquerade syndromes.
The paraneoplastic masquerade syndromes include cancer-associated retinopathy, melanoma-associated retinopathy, and bilateral diffuse uveal melanocytic proliferation. These masquerade syndromes can be differentiated from true uveitis by a detailed history and thorough physical examination, after which selective laboratory and ancillary testing can be used to confirm the diagnosis.
Upon completion of this Focal Points issue, you should be able to:
- Identify the risk factors that increase the odds that vitritis is likely to be caused by primary central nervous system lymphoma (PCNSL)
- Identify and differentiate ophthalmic features of PCNSL from other infectious and inflammatory causes of vitreous inflammation
- Discuss the importance, pathologic features, and yield of vitreous biopsy in the diagnosis and management of ocular PCNSL
- Differentiate clinical features and management of a hypopyon caused by retinoblastoma from other etiologies of hypopyon in the pediatric population
- Differentiate cancer-associated retinopathy from melanoma-associated retinopathy based on time of presentation (before or after diagnosis of primary cancer), visual field defects, and electrophysiologic testing
Focal Points issues are practical, hands-on discussions of the clinical challenges you face daily. Each issue delivers high-quality, trusted ophthalmic information written and reviewed by leading experts.
Subscribers receive 12 new issues a year, plus access to the Focal Points digital archive.
To access this issue from your laptop or desktop computer, log in to www.aao.org/myonlineproducts with your Academy username and password. To access this issue from your Apple iPad® or Android™ tablet, use the free AAO eBooks app. For more information about the app, visit www.aao.org/ebooks.
The American Academy of Ophthalmology designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Once you have completed this Focal Points issue, please visit CME Central to review or claim your CME.