一名 71 岁的女性左眼突然出现疼痛、视力下降，并伴有进行性不稳定。初步检查显示左侧视盘水肿，黄斑光学相干断层扫描证实存在视网膜内和视网膜下液体，以及视网膜色素上皮下的高反射物质。随后的研究，包括脑磁共振成像和全面的血清学分析，排除了传染性和自身免疫性原因，使诊断情况进一步复杂化。患者双眼视力继续恶化，提示需要进行经验性皮质类固醇治疗。虽然视力有所改善，但病情却发生了意想不到的转变，神经系统症状不断恶化。最终脑活检结果与弥漫性大 B 细胞淋巴瘤一致。版权所有 © 2024。由 Elsevier Inc. 出版。

A 71-year-old woman developed sudden, painful, decreased vision in the left eye accompanied by progressive instability. Initial examination revealed left optic disc edema, and macular optical coherence tomography confirmed the presence of intraretinal and subretinal fluid, as well as hyperreflective material under the retinal pigment epithelium. Subsequent investigations, including brain magnetic resonance imaging and a comprehensive serological analysis, ruled out infectious and autoimmune causes, further complicating the diagnostic picture. The patient's vision in both eyes continued to deteriorate, prompting empirical corticosteroid treatment. While the vision improved, the case took an unexpected turn with worsening neurological symptoms. Ultimately a brain biopsy was consistent with diffuse large B-cell lymphoma.Copyright © 2024. Published by Elsevier Inc.