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Noriyasu Hashida, Kei Nakai, Nobuyuki Ohguro, Kohji Nishida; Association Of Ocular Findings And Preventive Therapy With Onset Of Cerebral Involvement In Patients With Primary Intraocular Lymphoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6879.
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To investigate whether the site of the ocular lesions and prophylactic treatment in patients with primary intraocular lymphoma (PIOL) are associated with the time to onset of cerebral involvement.
We retrospectively studied 22 patients (5 men, 17 women; mean age, 66 ± 12 years) with a diagnosis of PIOL at our hospital between January 2001 and October 2011 and with at least 1-year follow-up after treatment. The Osaka University Medical School Ethics Committee approved the study protocol, and all patients provided informed consent. We analyzed the relation between the site of the ocular lesions and the onset of cerebral involvement by classifying the PIOL lesions into three types: vitreous opacity (VO) type, vitreous opacity of 2+ or higher without retinal lesions; retina type, vitreous opacity of 1+ or less with retinal lesions only; and combination type, with both. We also evaluated whether prophylactic treatment inhibited the onset of cerebral involvement by administering systemic chemotherapy or topical ocular treatments, such as intravitreal injections of methotrexate and rituximab, in patients with PIOL without cerebral involvement.
During a mean follow-up period of 38 ± 21 months, 14 (64%) patients had onset of cerebral involvement, including 3 (60%) of 5 patients with retina-type lesions, 5 (50%) of 10 patients with VO-type lesions, and 6 (86%) of 7 patients with combination-type lesions. There are no significant differences between the site of the ocular lesions and the onset of cerebral lesions (P=0.285). In addition, cerebral involvement occurred in 6 of 8 patients receiving prophylactic systemic chemotherapy and 8 of 14 patients receiving topical ocular treatments, with no significant difference between the two groups (P=0.649). The time to onset of cerebral involvement in the systemic chemotherapy group (50.2 ± 23.2 months) was significantly longer than that in the topical ocular treatment group (15.6 ± 13.6 months) (p = 0.004).
While prophylactic systemic chemotherapy did not inhibit the onset of cerebral involvement in patients with PIOL, it significantly prolonged the time to cerebral onset of disease.
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