Resolution of Lymphoma-associated Open-angle Glaucoma by Rituximab

Abstract

Open-angle glaucoma can result as a consequence of isolated conjunctival lymphoid tumors and can resolve with successful treatment of lymphoid lesions. The mechanism of glaucoma may be obstruction of aqueous outflow to the episcleral and conjunctival veins either by compression from a mass effect or direct infiltration that is relieved with resolution of the conjunctival lymphoid lesions. We believe this is a unique presentation of glaucoma associated with lymphoid tumors that has not been reported earlier.

A case of primary orbital lymphoma manifested as increased intraocular pressure

“…As is well known, intraocular lymphoma can lead to increased intraocular pressure through a variety of mechanisms. It mainly includes neovascular glaucoma caused by retinal in ltration or secondary to central retinal vein occlusion caused by lymphoma, secondary angle-closure glaucoma caused by direct invasion of the ciliary body 9 . But orbital lymphoma manifested as ocular hypertension is relatively rare.…”

“…In their opinion, the conjunctival lesions prevented adequate out ow of aqueous humor due to mass effect result in unilateral increase in intraocular pressure. Won I. Kim et al 9 also found that the invasion of periocular conjunctival lymphoma can increase the pressure in the super cial scleral veins, prevent the out ow of aqueous plexus and result in increased intraocular pressure, and it was not responsive to medical and laser therapy. And in the above two cases the marked feature of the clinical examination, except for the elevation of intraocular pressure, was a marked expansion of the extrascleral vein, which was absent in the contralateral eye.…”