Ischemic Retinopathy Associated With Mantle Cell Lymphoma–Induced Vascular Occlusion

<b>Purpose:</b> To describe a patient with bilateral ischemic retinopathy, likely attributable to vascular occlusion induced by mantle cell lymphoma. <b>Methods:</b> A case and its findings were analyzed. <b>Results:</b> A 54-year-old man presented with an 11-month history of significant vision loss in both eyes. His medical history was significant for mantle cell lymphoma with no signs of intraorbital involvement on magnetic resonance imaging. At presentation, the visual acuity was 20/400 OD and counting fingers OS, with an unremarkable anterior segment examination. On funduscopy, optic nerve pallor, sclerotic blood vessels, and cotton-wool spots were seen. Profound retinal nonperfusion and inner retinal layer loss were confirmed with fluorescein angiography and optical coherence tomography, with no signs of macular edema at the time of presentation. <b>Conclusions:</b> This report represents the first instance of bilateral ischemic retinopathy, likely originating from mantle cell lymphoma, presenting predominantly with ischemic retinal features and resulting in profound vision loss. With few cases documenting retinal involvement in mantle cell lymphoma, this report provides a better understanding of this rare pathology and its effect on retinal health.