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Lauren A Dalvin, Li-Anne S Lim, David Ancona-Lezama, Mehdi Mazloumi, Michael Chang, Arman Mashayekhi, Carol L. Shields; Survival Times in Patients with Vitreoretinal Lymphoma.
Analysis of 95 Patients at a Single Ocular Oncology Center.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3543.
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© ARVO (1962-2015); The Authors (2016-present)
Primary vitreoretinal lymphoma (VRL) is often associated with central nervous system (CNS) lymphoma and has a poor life prognosis. We performed a retrospective analysis to identify clinical factors predictive of survival time in patients manifesting VRL.
Patients diagnosed with cytologically-confirmed VRL at a single ocular oncology center from January 1, 1984 to July 30, 2018 were included. Records were reviewed for patient demographics, presenting clinical features, treatment methods (systemic chemotherapy, external beam radiotherapy, intravitreal chemotherapy), association with CNS or systemic lymphoma, and date and cause of death. Kaplan-Meier and Cox regression analysis were performed to assess mean survival time and hazard ratio using SPSS Statistics software.
There were 95 patients, 52 (55%) males and 43 (45%) females, with VRL. Mean patient age at diagnosis was 67 years (median 66, range 28-91 years). Ocular involvement was unilateral in 23 (24%) and bilateral in 72 (76%) patients. Associated CNS lymphoma was found in 50 (53%) patients, diagnosed before (n=36, 38%) or after (n=14, 15%) VRL diagnosis. Associated systemic lymphoma was found in 19 (20%) patients, diagnosed before (n=16, 17%) or after (n=3, 3%) VRL diagnosis. Both CNS and systemic lymphoma were found in 10 (11%) patients. The mean survival time after onset of ocular symptoms was 66 months and did not differ when comparing CNS lymphoma diagnosed before VRL versus after VRL versus no CNS lymphoma at presentation (67 vs. 60 vs. 64 months, p=0.84). The presence of subretinal pigment epithelial (sub-RPE) infiltration was associated with shorter mean time to death (46 vs. 76 months, p=0.04, hazard ratio [HR] 1.9). The mean survival did not differ by sex, age at presentation, association with systemic lymphoma, unilateral versus bilateral ocular involvement, presence of vitreous involvement, or primary method of VRL treatment (p>0.05).
Patients with VRL who present with sub-RPE infiltration have shorter mean survival time. Further studies are required to determine whether sub-RPE infiltration is associated with more aggressive CNS lymphoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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