Chorioretinal Atrophy in Vitreoretinal Lymphoma

Marchese, Alessandro; Cicinelli, Maria Vittoria; Cavalleri, Michele; Bandello, Francesco; Modorati, Giulio; Miserocchi, Elisabetta

doi:10.1097/iae.0000000000003352

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…In our case, the postoperative IOP was 16 mm Hg lower than the preoperative IOP. Unlike other surgeries or procedures commonly associated with ODR, such as trabeculectomy, glaucoma drainage implantation, and iridotomy, phacoemulsification, which was performed in this case, is rarely associated with ODR [1] . In this patient, the hemorrhage occurred in the intraretinal and preretinal areas.…”

Section: Discussionmentioning

confidence: 80%

“…However, the chemotherapeutic drugs might also have played a role via a toxic effect on the retinal vessels. ODR manifests as diffuse retinal hemorrhages following an acute lowering of the IOP [1] . Studies have revealed that the mean IOP decrease in ODR is 33.2±15.8 mm Hg (range, 4-57 mm Hg), with 82% of ODR events occurring on the first postoperative day [4] .…”

Section: Discussionmentioning

confidence: 99%

“…O cular decompression retinopathy (ODR), which manifests as diffuse retinal hemorrhage occurring abruptly in multiple locations, including the subretinal, intraretinal, and preretinal spaces, is a rare complication after glaucoma surgery and is caused by sudden, iatrogenic lowering of intraocular pressure (IOP). Implicated procedures include glaucoma drainage implantation, trabeculectomy, iridotomy, and even cataract surgery [1] . One report described a case of ocular decompression management following uncomplicated cataract surgery with no posterior capsular rupture or other intraoperative complications [2] .…”

Section: Dear Editormentioning

confidence: 99%

See 2 more Smart Citations

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy

Chen,

Liu,

et al. 2024

Int J Ophthalmol

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Dear Editormentioning

confidence: 99%

See 1 more Smart Citation

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy

Chen,

Liu,

et al. 2024

Int J Ophthalmol

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“…A worse visual outcome after treatment for VRL with subretinal infiltration and exudative retinal detachment is considered to result in RPE atrophy with secondary photoreceptor dysfunction 18 . Alessandro et al 19 reported that 52% (41 eyes of 79 eyes) of their VRL cohort showed chorioretinal atrophy (CRA) and the eyes with CRA had a significantly worse vision. Major risk factors of developing CRA were retinal infiltrates, vertical hyperreflective lesions, and macular involvement.…”

Section: Discussionmentioning

confidence: 99%

Clinical features predictive of vision loss in patients with vitreoretinal lymphoma: a single tertiary center experience

Kim

Suh

Park

et al. 2023

Sci Rep

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To clarify the long-term visual prognosis and prognostic factors for vision loss in patients with vitreoretinal lymphoma (VRL). This retrospective longitudinal study included 64 consecutive patients with VRL. We analyzed the best-corrected visual acuity (BCVA), optical coherence tomography findings, and clinical features at every visit. Significant vision loss was defined as a final BCVA ≥ 0.5 logMAR. Predictors of significant vision loss following treatment were evaluated using univariate and multivariate linear regression analyses. We included 113 eyes of 64 patients (mean age, 64.2 ± 10.9 years), and 49 patients (76.6%) showed bilateral ocular involvement. The mean follow-up duration was 35.4 ± 25.8 months. At diagnosis, 36 (56.3%), 17 (26.6%), and 11 (17.2%) patients had primary, secondary, and concurrent VRL, respectively. All eyes received intraocular methotrexate injections (mean, 17.1 ± 5.5 injections). The mean BCVA improved from 0.44 ± 0.28 at diagnosis to 0.33 ± 0.29 1 month after treatment initiation. Vision improved significantly after treatment (final mean BCVA, 0.24 ± 0.21). Univariate and multivariate analyses showed that baseline BCVA and retinal/subretinal infiltration were significantly correlated with vision loss. In this study, a good visual outcome was maintained for > 35 months in patients with VRL. Baseline BCVA and retinal/subretinal infiltration were significant predictors of vision loss after treatment for VRL.

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“…Of note, VRL can affect retinal periphery without macular involvement, and OCT scans can eventually report no signs of retinal involvement. 32 , 37 – 40 …”

Section: Multimodal Imagingmentioning

confidence: 99%

A comprehensive overview of diagnosis, imaging and treatment of vitreoretinal lymphoma

Menean,

Giuffrè,

Cicinelli

et al. 2023

European Journal of Ophthalmology

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Vitreoretinal lymphoma (VRL) is a rare B-cell intraocular neoplasia characterized by poor long-term prognosis and lack of effective therapies. It mainly involves the vitreous humor, the retina, and the retinal pigment epithelium (RPE), although anterior segment involvement can occur. VRL is classified as a lymphoma of immune privileged sites, along with testis lymphoma and primary central nervous system lymphoma (PCNSL). VRL and PCNSL are strictly connected indeed: 80% of VRL develop PCNSL, while 20% of patients with PCNSL present VRL during natural history of lymphoma. Due to the lack of worldwide consensus about diagnosis, therapy, and follow-up timing, VRL represents one of the most challenging ocular affections. VRL commonly masquerades as a posterior uveitis, and misdiagnosis often occurs because of partial response to topical steroids. Gold standard for diagnosis is cytological analysis of vitreous humor. However, this technique lacks sensitivity and supplemental molecular analyses can improve the diagnostic process. Multimodal imaging allows ophthalmologists to empower their clinical suspicion and a comprehensive examination can highlight typical features of VRL and justify further invasive procedures. There is no consensus about VRL therapy, and none of the therapeutical scheme has demonstrated to prevent cerebral involvement and improve patient's overall survival. Intravitreal injections of chemotherapeutics drugs, ocular radiation therapy and systemic chemotherapy can be considered in the treatment of VRL. Once cerebral involvement occurs, systemic chemotherapy must be included in the treatment as a life-saving therapy. Further multicentric studies are required to find out the best treatment of patients with VRL.

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Chorioretinal Atrophy in Vitreoretinal Lymphoma

Abstract: This study revealed the frequency, risk factors, and functional prognosis of chorioretinal atrophy associated with vitreoretinal lymphoma.

Cited by 7 publications

References 31 publications

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy

Clinical features predictive of vision loss in patients with vitreoretinal lymphoma: a single tertiary center experience

A comprehensive overview of diagnosis, imaging and treatment of vitreoretinal lymphoma

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