Abstract
Purpose: :
To evaluate the effectiveness of measuring anterior chamber interleukin (IL)-10 concentrations during treatment of primary vitreoretinal lymphoma with intravitreal injection of methotrexate.
Methods: :
Retrospective observational case series: Patients were diagnosed having vitreoretinal lymphoma by diagnostic vitrectomy. Treatment protocol included induction course of injections of 800 microg/0.1 mlMTX intravitrealy twice weekly for 4 weeks. IL-10 concentrations in the anterior chamber were measured at baseline and at the last injections using a standard enzyme-linked immunoassay. Informationswere collected from the patient records retrospectively.
Results: :
In the study 14 files were reviewed, mean age was 66 years(with a range of 44 to 81 ) ,10 out of 14 have moderate to severe vitreal infiltration(71%) ,11 patients (79%) had RPE irregularities ,average delay ofdiagnosis was 6.9 months. Eight eyes of 7 patients were treated with IVT methotrexate. Clinical remission, evaluated on clearance of vitreous malignant cells, was reached after the course of treatment with IVT methotrexate in 7 eyes out of 8 .The mean of IL10 at the diagnosis in those 8 eyes was 1045 pg/ml (range of 145 pg/ml -2500 pg/ml) while it decrease to 41 pg/ml at the end of treatment (range of 0 pg/ml -202 pg/ml) . None of the patients had an intraocular recurrence with a mean follow-up of 6 months. Two out of the 8 eyes (25%) experienced corneal epitheliopathy, which usually appeared at the beginning and subside few weeks after the end of treatment.
Conclusions: :
A decrease in the IL-10 seems to be related to a decrease in vitreous infiltrate. Measuring the IL-10 in the anterior chamber is observer independent and may be useful to evaluate therapeutic efficacy in vitreoretinal lymphoma. This method could be used for future treatment trial to free observer variability.
Keywords: oncology • tumors • retina