Systemic non-Hodgkin's lymphoma masquerading as Vogt–Koyanagi–Harada disease in an HIV-positive patient



A 29-year-old man presented with decreased visual acuity in both eyes secondary to exudative retinal detachment resembling Vogt–Koyanagi–Harada disease. Although fluorescein angiographic pictures supported the clinical findings, there was no choroidal thickening evident with ultrasonography. In 3 days he developed increased disc oedema with peripapillary haemorrhages in both eyes. Further evaluation revealed HIV-positive status and a systemic non-Hodgkin's lymphoma. The patient responded favourably to the treatment for systemic non-Hodgkin's lymphoma confirming our diagnosis of intraocular metastasis. In bilateral exudative detachment, an absence of choroidal thickening on ultrasonography and the presence of peripapillary haemorrhages should prompt a systemic evaluation for causes other than Vogt–Koyanagi–Harada disease, especially in HIV-positive patients.