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Jacob Pe'er, Ron Kaufman, Shahar Frenkel; The Use of Intravitreal Methotrexate for Treating Vitreoretinal Lymphoma . Invest. Ophthalmol. Vis. Sci. 2017;58(8):1800.
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© ARVO (1962-2015); The Authors (2016-present)
To report our 20 years' experience in treating vitreoretinal lymphoma by intravitreal methotrexate injections.
A retrospective analysis of all the patients with vitreoretinal lymphoma that were treated in the ocular oncology service of Hadassah Hebrew Universality Medical Center since March 1997. All the patients were treated by intravitreal injections of 400mg of methotrexate in 0.05-0.1 ml according to protocol of up to 25 injections.
During the 20 years we treated 108 eyes of 62 patients (39 females; 23 males). The age range 21-92 years (mean 61.5 years). In 46 patients (74.2%) both eyes were involved, and in 16 the disease was monocular (RE-7; LE-9) 58 patients had B-cell lymphoma and 4 T-cell lymphoma. In 47 patients (75.8%) the ocular disease accompanied primary CNS lymphoma. In 22 the ocular disease preceded the CNS lymphoma and in 25 the CNS lymphoma preceded the ocular disease. All patients responded fully to treatment after 2-16 injections and in only one eye was there a recurrence after completion of the treatment (was treated successfully by a full second course of methotrexate). The side effects were mostly superficial (conjunctival hyphemia and keratopathy) and temporary and were reduced when using the methotrexate injections to 0.05ml.
Intravitreal chemotherapy using methotrexate is a very effective way of treating vitreoretinal lymphoma with 100% success rate and rare recurrences, with only superficial and temporary side effects.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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