Risk Potentiality of Frontline Radiotherapy Associated Cataract in Primary Ocular Adnexal Mucosa-associated Lymphoid Tissue Lymphoma

Abstract

PurposeTo elucidate risk potentiality of frontline radiotherapy associated cataracts in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML).MethodsData from eight consecutive patients of 41 total OAML patients who had undergone cataract surgery after frontline radiotherapy were analyzed.ResultsThe median patient age was 46 years (range, 36 to 69 years). The median total radiation dose was 3,780 cGy (range, 3,060 to 4,500 cGy), and the mean duration from radiation irradiation to cataract surgery was 36.60 ± 8.93 months. Preoperative lens opacification was primarily at the posterior lens subcapsule, and best-corrected visual acuity (BCVA) was 0.43 ± 0.21. Patients underwent the phacoemulsification surgical procedure with posterior chamber intraocular lens insertion. The average BCVA improved to 0.90 ± 0.14 after cataract surgery. Two patients underwent posterior continuous curvilinear capsulorhexis, and one had posterior capsule rupture. For posterior capsule opacification (PCO), three patients received Nd:YAG laser posterior capsulotomy after the initial surgery, and one patient is currently under consideration for laser posterior capsulotomy.ConclusionsRadiotherapy increased posterior subcapsule opacification at a relatively young age in primary OAML. Phacoemulsification was a manageable procedure without severe complications, and final visual outcomes were good. However, because after-cataracts progressed earlier than did senile cataracts, close follow-up should be considered for PCO management.

Radiotherapy in the Management of Orbital Lymphoma

“…25 Posterior subcapsular cataracts are the cataract type that is most commonly seen following radiotherapy in the orbit. 26 Lens shielding has been found to reduce the incidence of radiation-induced cataracts in previous studies, 8,12,27,28 which was confirmed in our series. Cataracts were formed in 46% of patients who did not (Tables 5 and 6).…”

Outcomes of Primary Lymphoma of the Ocular Adnexa (Orbital Lymphoma) Treated with Radiotherapy

“…The pathogenesis of radiationrelated cataracts is debated and a threshold radiation dose for cataract development has not been established, but instead there seems to be a linear model of risk [31e33]. However, for patients developing radiation-related cataracts the outcome from surgery has been shown to be excellent [34]. The use of a lens-sparing technique prevented cataract formation, but was associated with a higher rate of acute erythema and conjunctivitis.…”

Extranodal Marginal Zone Lymphoma of Ocular Adnexa: Outcomes following Radiation Therapy

“…Twenty peer-reviewed articles were reviewed from 1997 to 2013 [4,8,12,14,15,16,22,23,24,25,26,27,28,29,30,31,32,33,34,35]. All patients treated with radiation therapy only were recorded.…”

“…The International Lymphoma Study Group classified 3 subtypes of MZL. This includes extranodal marginal zone B-cell lymphoma (EMZL), splenic marginal zone B-cell lymphoma, and nodal marginal zone B-cell lymphoma [1,2,7,8]. EMZL is the most frequent, low-grade, indolent, small B-cell lymphoma with a prolonged course of the ocular adnexa [9,10].…”