Abstract
Purpose: :
To describe the clinicals, paraclinicals, therapeutic management and outcome in patients with primary intraocular lymphoma
Methods: :
A retrospective study of 92 patients was assembled from 1 center between 1990 and 2007. Only immunocompetent patients with intraocular lymphoma with or without cerebral involvement were included ; none had systemic lymphoma. All patients had a histologic diagnosis.
Results: :
Median age at diagnosis was 63. Sixty-two percent were woman. Diagnosis was made by vitrectomy in 63%. Median time to diagnosis was 14 months. It was a large B-cell lymphoma in 96%. Initial visual acuity was 0,6 LogMAR. Initial exam showed for all patients a fibrillar vitreitis, bilateral in 81,5%, associated with multifocal subretinal infiltrates and retinal pigment épithélium atrophy in 70%. A cerebral involvement was associated in 73%. Initial therapeutic management was a chimiotherapy in 95%, associated with radiotherapy in 18% cases and a autologous stem-cell transplantation in 25%. Median follow-up was 34 months. Forty-two patients were death during study 27 months after diagnosis in mean. Median survival for entire cohort was 63,4 months. For the 23 patients treated by stem-cell transplantation median survival was 83,5 months ; it was 69,4 months for patients treated by chimiotherapy and radiotherapy. This différence was statistically signifiant (p=0,004). Survival rate was 25% at 5 years.
Conclusions: :
This is the largest reported series of primary intraocular lymphoma described by ophthalmolgist. Intensification therapeutic by autologous stem-cell transplantation seemed to extend median survival. But Diagnostic delay remained long and pronostic poor.
Keywords: uveitis-clinical/animal model • retina