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V. J. John, H. E. Grossniklaus, J. D. Wolfe, D. F. Martin, S. Srivastava; Primary Intraocular Lymphoma: A Large Single Center Study of Baseline Characteristics, Clinical History, Treatment and Prognosis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3507.
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© ARVO (1962-2015); The Authors (2016-present)
To define the baseline characteristics, initial clinical findings, natural history, and prognostic factors of patients with primary intraocular lymphoma.
Retrospective, consecutive case series of all intraocular lymphoma patients that were seen at Emory Eye Center between January 1990 and June 2009. Medical charts, operative reports, and pathology reports were reviewed. All cases were performed by one of three vitreoretinal surgeons at the same institution, and all the pathology specimens were evaluated by the same ocular pathologist. In most cases, the management of the patients was also undertaken by the medical oncology and radiation oncology departments at Emory University Hospital.
A total of 60 patients were identified. A pathological review of all cases was performed according to the WHO classification. Median follow-up was 90 months. Patients had an average age of 65, were mostly female [62% F vs. 38% M] and had no predilection for unilateral or bilateral presentations [52% vs. 48%]. Vision loss [58%] was the predominant initial presentation followed by floaters, and uveitis [67%] was the most common initial diagnoses of these patients prior to evaluation at Emory. Initial vision at time of presentation ranged extensively from 20/25 to light perception vision. Biopsy specimens were obtained mostly from the vitreous cavity [64%], followed by subretinal space, brain, and anterior chamber. Pathology revealed that all patients had a diffuse large B-cell intraocular lymphoma [DLBCL] at the time of diagnosis with CD19, 20 positivity noted in 25% of patients, and simultaneous CNS involvement in 40% of them. Treatment modalities varied from chemotherapy only [24%], radiation therapy only [4%], combined chemo/XRT [18%], and six patients receiving whole brain radiation.
Although a rare disease, our series represents one of the largest single center cohorts of intraocular lymphoma in the country. The site of biopsy specimens, the rates of CNS involvement, and the different modalities of treatments are similar to other published series.
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