Correspondence

Itty, Sujit; Olson, Joshua; O'Connell, D. J.; Pulido, José S.

doi:10.1097/iae.0b013e318196b1f6

Cited by 22 publications

(6 citation statements)

References 8 publications

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“…In addition to timely diagnosis, monitoring of treatment efficacy and detecting recurrence is also paramount 19 . Visual acuity and vitreous transparency have been the common criteria for assessing treatment efficacy and disease recurrence 20 – 22 . In this study, the serial changes in the IL-10 levels in the anterior chamber allowed an objective and less aggressive assessment for disease recurrence.…”

Section: Discussionmentioning

confidence: 99%

Serial changes in the aqueous IL-10 level after intravitreal methotrexate injection as an indicator of primary vitreoretinal lymphoma recurrence

Park

Kim

et al. 2020

Sci Rep

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Primary vitreoretinal lymphoma (PVRL) often masquerades as other uveitic diseases. We investigated the aqueous cytokine level changes and the effects of intraocular methotrexate (MTX) in patients with PVRL. In this retrospective consecutive case-series study, we reviewed the records of 14 consecutive patients with PVRL treated between 2018 and 2020. The concentrations of interleukin (IL)-2, IL-6, IL-10, IL-12, IL-17, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were determined at baseline and several time points after intravitreal MTX injections during follow-up. Markedly elevated IL-10 levels and a higher IL-10/IL-6 ratio were found in patients with PVRL. The aqueous levels of IL-10, IL-12, and TNF-α, and the IL-10/IL-6 ratio significantly decreased at 1 month after intravitreal MTX therapy onset compared with the baseline values (P = 0.001, 0.002, 0.001, and 0.001, respectively). The mean duration to normalized IL-10 levels was 1.17 ± 0.4 months. Where serially recorded IL-10 levels were available, regular intravitreal MTX treatment was associated with rapid reduction in IL-10 levels, while elevated IL-10 level was associated with disease recurrence. Elevated IL-10 levels and high IL-10/IL-6 ratio may aid in the diagnosis of PVRL. Aqueous IL-10 level monitoring can help assess the therapeutic response and indicate disease recurrence.

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Section: Discussionmentioning

confidence: 99%

Serial changes in the aqueous IL-10 level after intravitreal methotrexate injection as an indicator of primary vitreoretinal lymphoma recurrence

Park

Kim

et al. 2020

Sci Rep

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“…Orbital radiation can lead to remission, but there are many adverse events, such as dry eye, optic neuropathy and retinopathy, and it does not prolong survival. Rituximab given both systematically and intravitreally was used based on its efficacy, with a good initial response, but subsequent relapse required intravitreal MTX and radiation [5,6]. PIOL is associated with a poor prognosis, with patients dying of CNS disease; therefore appropriate diagnosis is crucial for the treatment.…”

Section: Discussionmentioning

confidence: 99%

Primary Intraocular Diffuse Large B-cell Lymphoma: Diagnostic Difficulties in Deep Retinal Infiltrations with Vitritis

Kapelko-Słowik

Urbaniak-Kujda

Turno-Kręcicka

et al. 2015

Indian J Hematol Blood Transfus

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Purpose Primary intraocular lymphoma (PIOL) is a rare malignancy with an aggressive clinical course. It is usually considered as a subset of primary central nervous system lymphoma. Differential diagnosis should include infectious and non-infectious aetiologies, particularly the common masqueraders sarcoidosis, tuberculosis, viral retinitis and syphilis. Patient The article presents a case of bilateral vitreoretinal lymphoma manifesting as uveitis and vitritis resistant to corticosteroid therapy. The final diagnosis was based on a retinal biopsy. Results The patient was successfully treated with systemic and local therapy. Long-term complete remission (CR) was reached. The relapse of diffuse large B-cell lymphoma was revealed in the frontal left lobe after 48 months of CR duration. Conclusion The diagnosis of PIOL is always very difficult. Cooperation of pathologists, ophthalmologists and hematologists is required for a quick and accurate diagnosis. Local and systemic treatment is needed to achieve CR, but the relapse rate remains very high.

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“…The combination of rituximab with high-dose methotrexate may improve the complete remission rates as well as the overall and progression-free survivals in immunocompetent patients with newly diagnosed PCNSL (78). Rituximab-based intravitreal chemotherapy has been reported to be safe and effective to induce remission in a majority of eyes with vitreoretinal lymphoma (79–81). Larkin et al treated 48 eyes of 34 vitreoretinal lymphoma patients with a median of 3.5 intravitreal injections of rituximab for new diagnosis (68.8%), progressive disease (29.9%) and maintenance therapy (2.1%).…”

Section: Pvrl Treatmentmentioning

confidence: 99%

Case 01-2017—Primary vitreoretinal lymphoma (PVRL): report of a case and update of literature from 1942 to 2016

2018

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Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinical diagnosis challenging. Vitreous cells, subretinal lesions and imaging techniques are essential for clinical diagnosis. Importantly, cytopathology/histopathology identification of malignant cells is the gold standard for the diagnosis of PVRL. In addition, molecular detection of immunoglobulin heavy chain (IgH) or T cell receptor (TCR) gene rearrangements, immunophenotyping for cell markers, and cytokine analysis of interleukine-10 elevation are often used as adjunct procedures. Current management of PVRL involves local radiation, intravitreal chemotherapy (methotrexate and rituximab), with or without systemic chemotherapy depending on the involvement of non-ocular tissues. In cases with concomitant PCNSL, systemic high-dose methotrexate/rituximab based therapy in conjunction with local therapy, whole brain radiotherapy and/or autologous stem cell transplantation is considered. Although PVRL normally responds well to initial treatment, high rates of relapse and CNS involvement usually lead to poor prognosis and limited survival. A professional team of medical experts in ophthalmologists, ocular pathologists, neuro-oncologists and hemato-oncologists is essential for optimizing patient management.

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Correspondence

Cited by 22 publications

References 8 publications

Serial changes in the aqueous IL-10 level after intravitreal methotrexate injection as an indicator of primary vitreoretinal lymphoma recurrence

Serial changes in the aqueous IL-10 level after intravitreal methotrexate injection as an indicator of primary vitreoretinal lymphoma recurrence

Primary Intraocular Diffuse Large B-cell Lymphoma: Diagnostic Difficulties in Deep Retinal Infiltrations with Vitritis

Case 01-2017—Primary vitreoretinal lymphoma (PVRL): report of a case and update of literature from 1942 to 2016

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