Purchase this article with an account.
Nicole Stuebiger, Gregor Willerding, Kristoph Jahnke, Agnieszka Korfel, Joussen Antonia, Vinodh Kakkassery; Therapy With Intravitreal Rituximab In Primary Vitreo-retinal Lymphoma (pvrl). Invest. Ophthalmol. Vis. Sci. 2012;53(14):4942.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Intravitreal injection of methotrexat (MTX) for primary vitreo-retinal lymphoma (PVRL) results in a higher concentration, a better effect in the eye and less systemic side effects compared to systemic therapy. The chimeric monoclonal CD20 antibody rituximab offers a potentially new intravitreal treatment option and used successfully for treatment of ZNS Lymphoma. In our case series, we report about clinical course after repeating intravitreal injections of rituximab for PVRL.
Diagnose of PVRL were confirmed by clinical investigation in three case (additional vitreous biopsy in one patient). Two patients were pretreated with systemic chemotherapy (ifosfamid - infiltration of the optic disc, MTX - primary ZNS lymphoma). Ocular clinical findings (visual acuity, intraocular pressure, vitreous haze, tumor size) were recorded before and after rituximab therapy. Intravitreal 1mg/0,1mL rituximab injections were conducted in accordance with the German Ophthalmic Society guidelines. Data were implemented in a nationwide open register for PVRL supported by the German Federal Ministry of Education and Research.
5 eyes from 3 patients received minimum 1 to maximum 7 rituximab injections. After a follow up of 4-30 months, we observed a significant reduction of vitreous haze in all eyes (measured by Nussenblatt classification), a preserved constant visual acuity or improvement (two eyes: finger count to 20/32; 20/40 to 20/32) and regressive tumor size. All patients reported about a reduction of discomfort after therapy. No intraocular adverse effects have been observed.
In our case series, we demonstrated advancement in clinical findings of PVRL and, to some extent, visual acuity without adverse intraocular side effects after intravitreal rituximab injections. Further long-term studies are necessary to illuminate local and systemic effects and possible side effects after rituximab therapy for intraocular lymphoma.
This PDF is available to Subscribers Only