Abstract
Purpose: :
Interleukin–10 (IL–10) is a known, sensitive marker to detect PIOL. The aim of this study was to evaluate the decrease of IL–10 levels in the aqueous humor of patients treated with intravitreal injections of methotrexate for the management of primary intraocular lymphoma, or primary central nervous system lymphoma (PCNSL).
Methods: :
Before intravitreal injection of methotrexate, anterior chamber tap was performed to evaluate the level of IL–10 at baseline. Methotrexate was injected intravitreally twice or once a week according to local tolerence. IL–10 dosage was performed by ELISA in the same laboratory. Levels of IL–10 were evaluated once a week during the treatment.
Results: :
Eight patients with intraocular B cell lymphoma and one patient with intraocular T cell lymphoma were included between 1999 and 2005 in this prospective study. Mean age was 70.5 years (54–82). Time of follow–up from the first injection of methotrexate was 2 to 31 months (median 16.2 months). Mean IL–10 levels before intravitreal treatment was 1056 pg/ml. After an average of 14 days, mean IL–10 levels was significantly decreased (150.3 pg/ml, p<0.01). Four patients required a further course of intravitreal chemotherapy for intravitreal recurrence. A second remission could be induced in these patients. Six patients died of CNS complications among whom, one had ocular relapse.
Conclusions: :
IL–10 seems to be an interesting parameter to follow during the management of patients undergoing intravitreal chemotherapy for PIOL. Furthermore, recurrences may be detected. The rapid kinetics of decrease during treatment and after the first two injections within the first 15 days, makes IL–10 a good marker of efficacy, closely related to clinical evolution.
Keywords: tumors • cytokines/chemokines • inflammation