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D.B. Greenman, G.F. Reed, S.D. Mellow, R.B. Nussenblatt, G.A. Levy–Clarke; Primary Intraocular Lymphoma–A Descriptive Analysis of 2 Decades of Experience at the NEI . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2823.
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© ARVO (1962-2015); The Authors (2016-present)
To describe 2 decades of the clinical features associated with the initial presentation of primary intraocular lymphoma (PIOL) at the National Eye Institute (NEI).
Medical records of thirty patients with a confirmed diagnosis of intraocular lymphoma followed at the National Eye Institute (NEI) were reviewed. Data on age, sex, time of diagnosis, visual acuity, presence of lymphoma in the cerebrospinal fluid (CSF), presence of brain lesions on MRI, degrees of inflammation in the vitreous, and presence of posterior pole lesion(s) was documented. Analysis of the data was performed using SAS (Cary, N.C.) including descriptive statistics and student t–test between groups.
All patients were divided into two groups, based on the date of their initial NEI visit. There were 15 patients in the 1985–1995 group (1) and 15 patients in the 1996–2005 (2). The mean age in group 1 was 51.6 compared to 58.6 in group 2. There was </=2+ vitritis in 13 patients in group 1 compared to 6 patients in group 2 (P<.017). Median age at diagnosis was 48 in group 1 compared to 57 in group 2. The mean length of symptoms prior to diagnosis in months was 18 in group 1 and 12 in group 2. The mean visual acuity on presentation was 20/50 (logmar–0.4) in group 1 and 20/80(logmar–0.64) in group 2. The number of patients with positive CSF was 4 in group 1 and 2 in group 2. The number of patients with positive brain lesions on MRI was 7 in group 1 and 6 in group 2. The number of eyes with posterior pole lesions in at least one eye was 9 in both groups. The number of eyes with 20/40 (logMar–0.3) or better was 62 % (37/60). The number of patients with 20/400 (logMar–1.30) or worse was 30% (9/30). There were 2 patients with T–cell lymphoma, 1 patient with an EBV associated lymphoma (HIV positive), and all other patients had large B–cell lymphoma, 90% (27/30). The only statistically significant difference between groups was for the degree of vitreous inflammation.
The basic features described were similar in both groups: a chronic bilateral posterior or intermediate uveitis, in general good vision compared to ocular findings, age of presentation in the 5th–6th decade, brains lesions on MRI and histo–pathologic evidence of malignant B–cells. This is consistent with previous reports. A comparison of the 2 groups revealed a statistically significant difference in the degree of vitreous inflammation in the earlier group compared to the later group. This may represent an improvement in the ability to diagnose patients earlier. A planned multi–center analysis will further delineate this question.
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