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Irina Belinsky, Song Eun Lee, William M. Schiff, Brian P Marr; Incidence of retinal detachment in primary vitreoretinal lymphoma (VRL).. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3417.
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Primary vitreoretinal lymphoma (VRL) is rare but potentially fatal, presenting a diagnostic and therapeutic challenge by masquerading as infectious or inflammatory conditions. We have observed an increased incidence of retinal detachment in our cohort of patients with VRL. To characterize this observation further, we studied this population with attention to demographics, clinical course, and treatment.
Retrospective review of 26 consecutive cases at a large Ocular Oncology Center.
Between 2006 and 2014, a total of 26 patients (44 eyes) were identified with primary vitreoretinal lymphoma, of whom 81% were female and 19% male, 92% were Caucasian, and the mean age at presentation was 62 years. The mean follow up period was 32 months. 81% (n=21) had biopsy proven VRL and 29% (n=5) were diagnosed clinically. 69% (n=18) had bilateral disease and 31% (n=8) unilateral. 27% (n=7) of patients had a history of retinal detachment (RD), 86% (n=6) unilateral and 14% (n=1) bilateral and one patient developed a recurrent RD in one eye, totaling 9 retinal detachments in this cohort. 33% (n=3) of RD’s occurred prior to the diagnosis of VRL, 56% (n=5) of RD’s occurred at presentation, and 11% (n=1) occurred during the course of the disease. 89% (n=8) received some form of surgical treatment, with no recurrences except one to date. 58% (n=15) of patients had associated primary central nervous system lymphoma (PCNSL) and 12% (n=3) died as a result of their lymphoma.
We observe a high incidence of retinal detachment in patients with primary vitreoretinal lymphoma. The etiology of this association is unclear. Retinal detachments may be caused by some effect of lymphoma on the vitreous, the retina, or the interface. Furthermore, these patients receive numerous diagnostic and therapeutic interventions. Further studies with more patients and longer follow up are needed. We propose that this observation is clinically relevant and warrants careful surveillance for retinal detachment during follow up and treatment as well as patient counseling.<br />
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