Abstract
Aims 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 11 years between 1990 and 2000. Categorical factors influencing survival were examined by the Kaplan–Meier estimator and groups compared with the log rank test.
Results A total of 14 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 4 months before diagnosis. In all, 10 patients had B-cell lymphoma, three patients T-cell lymphoma and one null-cell. Four patients had prior systemic lymphoma. Eight patients had primary central nervous system non-Hodgkin's lymphoma (PCNSL). Treatment included combined radiation to the eye and chemotherapy in 10 patients. Complications of radiotherapy 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%). A total of 11 patients died of lymphoma (79%). One has residual ocular disease, while two have survived for more than 5 years from initial presentation. Although currently disease free, one of these has a poor visual outcome with acuity less than 6/60 secondary to ocular complications of treatment.
Conclusions Our study had 29% with prior systemic lymphoma, 57% associated with PCNSL and 14% with intraocular disease only. 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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Acknowledgements
We would like to thank Dr KH Liew for reading and reviewing the discussion as related to radiation oncology. We also thank the numerous ophthalmologists, general practitioners, neurologists and radiation oncologists, as well as the multitude of medical record staff for their assistance and allowing access to clinical data. The staff of the various pathology labs (Alfred Hospital, Cabrini Hospital, Monash Medical Centre and Dorevitch Pathology) are acknowledged for allowing access and review of slides where available.
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None of the authors have any proprietary interest related to this article. This work was presented in part in poster format at the Association of Research in Vision and Ophthalmology Annual Meeting, Fort Lauderdale, Florida (May 2002)
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Hoffman, P., McKelvie, P., Hall, A. et al. Intraocular lymphoma: a series of 14 patients with clinicopathological features and treatment outcomes. Eye 17, 513–521 (2003). https://doi.org/10.1038/sj.eye.6700378
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DOI: https://doi.org/10.1038/sj.eye.6700378
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