20 November 2025
: Case report 
Ocular Involvement in Post-Transplantation Lymphoproliferative Disorder: A Rare Case with Rituximab Hypersensitivity
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Educational Purpose (only if useful for a systematic review or synthesis)
Jing-yi Liu
AE 1,2,3,4, Wan-Ting Zhang BE 1,2,3,4, Kang Wang D 5, Ying Liu D 1,2,3,4, Lin Wei D 2,3,4, Wei Qu E 2,3,4, Zhi-Gui Zeng DF 2,3,4, Zhi-Jun Zhu D 2,3,4, Li-Ying Sun AB 1,2,3,4*
DOI: 10.12659/AJCR.949884
Am J Case Rep 2025; 26:e949884
Table 1 Characteristics of intraocular PTLD in children.
| No. | Reference | Sex | Age at transplan-tation (months) | Organ | Immuno-suppression | LT to PTLD (months) | PTLD type | L/R | Other organ involved | EBV DNA in blood | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Bata BM. (2018) [], Astafurov KV. (2021) []20 | M | 36 | Heart | ATG, PND, CyA, SRL, MMF | 60 | Monomorphic B-cell (EBER-positive) | B | None | peaked at 19,800 copies/mL | RIS, topical steroid injection, RTX, radiotherapy, MTX | Alive |
| 2 | Hsu CT. (2019) []2 | M | 24 | Liver | CyA | 127.6 | Polymorphic B-cell (EBER-positive) | NA | None | 2900 copies/mL | RIS, RTX, Intravenous steroids | Alive |
| 3 | Iu LP. (2015) []22 | F | 6 | Liver | Tac | 22 | Polymorphic B-cell (EBER-positive) | R | Diffuse LNs, buccal mucosa | NA | RIS, RTX | Alive |
| 4 | Chen YW. (2015) []23 | F | 72 | Liver | CyA | 60 | NA | L | None | Positive | RIS, topical steroid injection | Alive |
| 5 | Schubert S. (2009) []24 | NA | 42 | Heart | NA | 50 | Monomorphic (EBER-positive) | NA | None | NA | RIS, radiotherapy, surgery | Alive |
| 6 | Schubert S. (2009) []24 | NA | 39 | Heart | NA | 32 | NA | NA | None | NA | RIS, T cell therapy | Alive |
| 7 | Lu BR. (2009) []25 | F | 96 | Liver | CyA, Aza, PND | 60 | Polymorphic B-cell (EBER-positive in lymph node) | L | Diffuse LNs | 5000 genomes per 105 lymphocytes | RIS, antiviral drugs, chemotherapy, Intravenous steroids | Died (central nervous system lympho-ma) |
| 8 | Fujita S. (2006) []26 | F | 60 | Liver | Tac, MMF, PND | 46 | Polymorphic B-cell (EBER-positive) | L | None | NA | RIS, topical steroid injection, antiviral drugs, radiotherapy | Alive |
| 9 | Bradfield YS. (2005) []27 | F | 4 | Liver | PND, CyA | 55 | Monomorphic B-cell | R | None | Positive | RIS, antiviral drugs, topical steroid injection | Alive |
| 10 | Rohrbach JM. (2004) []28 | M | 36 | Heart | CyA, Aza | 48 | Polymorphic B-cell (EBER-positive) | B | None | Positive | RIS, antiviral drugs, topical steroid injection, surgery, radiotherapy | Alive |
| 11 | Al-Attar. L (2004) []29 | F | 132 | Kidney | PDN, MMF, CyA, CPA | 23 | Monomorphic B-cell (EBER-positive) | B | None | Positive | RIS, topical steroid injection | graft loss |
| 12 | Cook. T (2001) []30 | F | 4 | Liver | CyA, PDN | 55 | Polymorphic B-cell | R | None | Positive | NA | NA |
| 13 | Cho. (2001) []31 | F | 120 | Liver | Tac, PDN, CyA | 68 | NA | B | Diffuse LNs | Positive | RIS, topical steroid injection | Alive |
| 14 | Cho. (2001) []31 | F | 60 | Liver | PDN, Aza, CyA | 53 | NA | B | Diffuse LNs | Positive | RIS, topical steroid injection, antiviral drugs | Alive |
| 15 | Cho. (2001) []31 | M | 168 | Heart | Aza, CyA | 61 | B-cell (EBER-positive) | L | None | Positive | RIS, antiviral drugs | Alive |
| 16 | O’Hara M. (2001) []32 | F | 18 | Liver | PDN, CyA | 102 | Polymorphic (EBER-positive) | L | None | NA | RIS, radiotherapy, surgery | Alive |
| 17 | O’Connor JA. (2001) []33 | F | 19 | Liver | PDN, CyA, Tac | 72 | Polymorphic B-cell (EBER-positive) | L | None | NA | RIS, radiotherapy, topical steroid injection, surgery | Alive |
| 18 | Chan. (2000) []34 | F | 3 | Heart | PDN, Aza, CyA | 45 | Monomorphic B-cell (EBER-positive) | L | Diffuse LNs | NA | RIS, antiviral drugs, CTX, radiotherapy, topical steroid injection | Alive |
| 19 | Clark WL. (1998) []35 | M | 4 | Liver | PDN, CyA | 21 | Polymorphic | R | None | Positive | RIS | Alive |
| 20 | Pomeranz HD. (1996) []36 | F | 14 | Liver | PDN, CyA | 34 | Monomorphic | L | None | NA | RIS, chemotherapy, Intravenous steroids | Alive |
| 21 | Brodsky MC. (1991) []37 | F | 43 | Liver | PDN, CyA | 41 | Polymorphic B-cell | B | None | Positive | RIS, topical steroid injection, radiotherapy, surgery | Alive |
| ATG – anti-thymocyte globulin; PND – prednisone; CyA – cyclosporine A; SRL – sirolimus; MMF – mycophenolate mofetil; Tac – tacrolimus; Aza – azathioprine; CPA – cyclophosphamide; RIS – reducing immunosuppression; RTX – rituximab. | ||||||||||||