June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Efficacy of intravitreal methotrexate and rituximab for intraocular diffuse large B-cell lymphoma
Author Affiliations & Notes
  • William S Gange
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Scott CN Oliver
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Footnotes
    Commercial Relationships   William Gange None; Scott Oliver Castle Bioscience, Code C (Consultant/Contractor), Roche/Genentech, Regeneron, Aura Bioscience, Code F (Financial Support)
  • Footnotes
    Support  Unrestricted Research Grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 699 – F0224. doi:
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    • Get Citation

      William S Gange, Scott CN Oliver; Efficacy of intravitreal methotrexate and rituximab for intraocular diffuse large B-cell lymphoma. Invest. Ophthalmol. Vis. Sci. 2022;63(7):699 – F0224.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the relative efficacy of intravitreal methotrexate and rituximab for treatment of intraocular lymphoma.

Methods : Single-center retrospective chart review of patients with intraocular diffuse large B-cell lymphoma (either primary vitreoretinal lymphoma or secondary from a non-central nervous system primary) who received either intravitreal methotrexate or rituximab as part of their treatment course. Patients were excluded if they were diagnosed with central nervous system lymphoma prior to onset of eye involvement. Time to ocular remission (<1+ vitreous cells or vitreous tap with no evidence of disease), progression free survival (PFS), and overall survival (OS) were compared for patients receiving intravitreal methotrexate and rituximab. PFS was calculated as time from onset of treatment to recurrence of ocular disease (≥1+ vitreous cells or positive vitreous tap) and OS was calculated as time from onset of treatment to death.

Results : 18 eyes of 11 patients were included. 4/11 (36.3%) patients were female, and median age at diagnosis was 59 (range 42-83). 8/11 (72.7%) patients had primary vitreoretinal lymphoma and 3/11 (27.3%) patients had secondary intraocular lymphoma from a systemic non-central nervous system primary. 7 patients (10 eyes) received intravitreal methotrexate and 4 patients (8 eyes) received intravitreal rituximab as initial intravitreal therapy. All 18 eyes receiving intravitreal injections achieved ocular remission at some point during their course. Ocular remission occurred after a median of 3 injections (range 2-9) in the methotrexate group and 3 (range 2-7) injections in the rituximab group. Mean number of total injections in the entire sample was 10.4 (SD 4.2) per eye. Mean PFS was 54.6 ± 5.2 months (44.5 to 63.7 95% CI) for patients receiving methotrexate compared with 15.4 ± 3.4 months (8.7 to 22.1 95% CI) for patients receiving rituximab. Mean OS was 53.2 ± 5.8 months (41.8 to 64.6 95% CI) for patients receiving methotrexate and 48.5 ± 12.2 months (24.7 to 72.4 95% CI) for patients receiving rituximab.

Conclusions : Both rituximab and methotrexate are effective treatments for intraocular lymphoma, resulting in ocular remission after a median of 3 injections. Patients receiving methotrexate had a longer ocular progression free survival than those receiving rituximab, though mean overall survival was similar in both groups.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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