Combined treatment of primary vitreoretinal lymphomas significantly prolongs the time to first relapse

Abstract

Combined treatment of primary vitreoretinal lymphoma significantly delays the relapse of lymphoma compared with local therapy alone. Intraocular involvement brings significant positive prognostic value when overall survival is compared.

Multiple evanescent white dot syndrome and panuveitis: a case report

“…Syphilitic chorioretinitis was denied from negative infectious serology. In patients with intraocular lymphoma, the recurrence of ocular involvement is common and the survival rate is poor [4], even if ocular lesions initially respond with systemic corticosteroid treatment. In our case, favorable visual and systemic prognosis with no recurrence of intraocular inflammation for a long-term follow-up period is incompatible with the clinical course of intraocular lymphoma, although vitreous biopsy was not performed.…”

Augenbefall und Systemerkrankung – periokuläre und intraokuläre Lymphome

“…Die Radiotherapie ist in der Lage, gute Ergebnisse in Bezug auf die Regression zu liefern, jedoch sind die Nebenwirkungen für das Augenlicht bedrohlicher [5,7,10]. Kombinierte Therapieformen aus systemischer Therapie und intravitrealer oder Strahlentherapie zeigten sich ebenfalls effektiv [9,10,27] [7]. Unsere Empfehlungen für das Therapieregime weichen ein wenig von diesen doch älteren Empfehlungen ab und orientieren sich an neueren Studien [9,27].…”

“…Kombinierte Therapieformen aus systemischer Therapie und intravitrealer oder Strahlentherapie zeigten sich ebenfalls effektiv [9,10,27] [7]. Unsere Empfehlungen für das Therapieregime weichen ein wenig von diesen doch älteren Empfehlungen ab und orientieren sich an neueren Studien [9,27]. Aufgrund neuster Daten und der allgemeinen internationalen Expertenmeinung wird sowohl beim isolierten PVRL als auch beim PVRL mit PZNSL eine Kombination aus systemischer und intravitrealer Therapie nach Maßgabe des Tumorboards empfohlen.…”

Intraocular chemotherapy for vitreoretinal lymphoma: A review

“…Subsequent to the original clinical case series, medical centres in North America, Europe, the Middle East and Asia also have reported their experience in treating groups totalling at least 177 eyes of 114 patients with VRL, [34][35][36][37][38][39][40] as well as multiple individual patients, [41][42][43][44][45] using intravitreal methotrexate injections. Additional reports have described groups of patients suffering from VRL, who received a range of treatments that included methotrexate and/or rituximab intravitreal injections (see below).…”

“…In contrast, as reported in 2019, for 66 patients with VRL treated at Mayo Clinic with systemic and ocular therapy (primarily intravitreal methotrexate, rituximab and/or corticosteroid therapy) had significantly longer failure-free and CNS relapse-free survival, but no increase in overall survival than patients treated with local or systemic treatment alone. 22 A smaller 2018 report from Charles University and General Hospital University (Prague, Czech Republic) 39 provided additional data in support of a combined extensive and local treatment approach to VRL: in 10 patients with primary VRL, combined therapy with intravitreal methotrexate extended progression-free survival, but not overall survival. Two non-comparative studies from Japan involving 27 patients with VRL provide further support for combination treatment, including intravitreal methotrexate as ocular therapy, for primary VRL.…”