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A Hall, PM Hoffman, P McKelvie, RJ Stawell, JD Santamaria; Intraocular Lymphoma: A Series of 14 Patients With Ocular and Systemic Clinicopathological Correlation and Treatment Outcomes . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2238.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the clinical features, pathology, mortality (systemic outcome) and ocular complications (visual outcome) of a cohort of patients treated for intraocular lymphoma. Methods:Retrospective case analysis of medical records and review of pathology of a consecutive series of patients presenting with intraocular lymphoma in Melbourne over eleven years between 1990-2000. Categorical factors influencing survival were examined by the Kaplan-Meier estimator and groups compared with the log rank test. Results:Fourteen patients were included. The median age of onset of symptoms was 62.5 years. Most were male (64%) and had bilateral eye involvement (64%). The commonest presentation was vitritis in 12 patients, with a median delay of four months before diagnosis. Ten patients had B-cell lymphoma, three patients T-cell lymphoma and one null-cell. Four patients (29%) had prior systemic lymphoma. Eight patients (57%) had primary central nervous system non-Hodgkin's lymphoma (PCNSL). Comparing the ocular features in the three patients with T-cell lymphoma with the ten with B-cell disease and the 8 patients with CNS disease with the 4 with systemic disease showed approximately similar proportions with bilateral disease, anterior uveitis, vitritis and choroidal involvement. Treatment included combined radiation to the eye and chemotherapy in 10 patients. Complications of treatment included cataract in five (50%), dry eyes in four (40%), punctate keratopathy in two (20%), radiation retinopathy in two (20%) and optic atrophy in one (10%). Eleven patients died of lymphoma (79%). One has residual ocular disease, while two have survived for more than five years from initial presentation. Though currently disease free, one of these has a poor visual outcome with acuity less than 6/60 secondary to ocular complications of treatment. Conclusion:Our study had 29% with prior systemic lymphoma, 57% associated with PCNSL and 14% with only intraocular disease. There were no differentiating ocular clinical features between those patients with systemic disease and those with CNS disease or between T cell and B cell lymphomas. Overall survival is low (21%) and relapses common in those surviving beyond 12 months. Visual outcome in survivors is very poor due in large part to significant complications from radiotherapy.
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