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D.D. Klisovic, M. Maqsood, L.A. Teasley, F. Hochberg, C.S. Foster; Primary Intraocular Lymphoma: A Retrospective Analysis Of Treatment And Mortality . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2830.
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To compare the mortality rate in patients with Primary Intraocular Lymphoma (PIOL) using predominately High Dosage Methotrexate (HD–MTX) therapy to historical standards of therapy.
This is a retrospective comparative study.We identified 74 Massachusetts General Hospital patients with biopsy–positive Primary Central Nervous System Lymphoma (PCNSL) with a co–diagnosis of Primary Intraocular Lymphoma (PIOL), of which charts were eliminated if they could not be located or were not well documented, rendering a final sample size of n = 37. These names were de–identified and the records analyzed for treatment modalities, length of treatment(s), type and duration disease response(s) and mortality. These values were then compared to those documented in peer–reviewed medical literature.
Approximately 54% of patients presented with ocular symptoms first, compared to 35% brain first and 11% both. Patients had a blend of therapies all including HD–MTX. While 57% of patients received radiation therapy, the majority received this modality first (57%) and this may reflect more the historical standard of care. The average survival was 54 months in the HD–MTX treated group as compared to a historical range of 12 – 42.5 months in patients treated with radiation therapy alone and radiation therapy with standard chemotherapy. The average presenting age of 60 and the predominance of females correlated with that seen in historical data.
HD–MTX has reduced the mortality rate from this rare and fatal disease. Cataracts due to use of steroids, vitrectomies and radiation therapy lead the list of complications of treatment. The majority of PIOL patients develop PCNSL also.
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