Intraocular T-cell Lymphoma: Clinical Presentation, Diagnosis, Treatment, and Outcome

Ocul Immunol Inflamm. 2017 Oct;25(5):639-648. doi: 10.3109/09273948.2016.1139733. Epub 2016 Mar 22.

Abstract

Purpose: To report on the clinical data of seven patients with T-cell intraocular lymphoma (IOL).

Methods: Retrospective case series.

Results: Seven immunocompetent patients, 12 eyes, 6 women, with T-cell-IOL were included from five countries. Mean age was 53.5 years (range: 25-82). Four patients had systemic-ocular lymphoma, two had CNS-ocular lymphoma, and one had systemic-CNS- ocular lymphoma. Vitritis was the most frequent clinical sign, followed by anterior uveitis and serous retinal detachment. Cytopathologic examination was performed on all ocular specimens (vitreous in six and iris mass biopsy in one patient). Adjunctive diagnostic procedures included immunohistochemistry, molecular tests, and cytokine profiling of vitreous samples. Treatment modalities included systemic chemotherapy (five patients), intravitreal methotrexate (three patients), globe radiotherapy, and intrathecal chemotherapy. Mean survival from diagnosis was 21.7 months (range: 2-69). Two patients are still alive.

Conclusions: T-cell IOL has variable clinical manifestations and prognosis. Systemic involvement, SRD, and vitreoretinal involvement were frequently observed.

Keywords: Intraocular lymphoma; T-lymphoma; primary vitreoretinal lymphoma; uveitis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Central Nervous System Neoplasms* / diagnosis
  • Central Nervous System Neoplasms* / drug therapy
  • Eye Neoplasms* / diagnosis
  • Eye Neoplasms* / drug therapy
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Injections, Spinal
  • Intraocular Lymphoma* / diagnosis
  • Intraocular Lymphoma* / drug therapy
  • Intravitreal Injections
  • Lymphoma, T-Cell* / diagnosis
  • Lymphoma, T-Cell* / drug therapy
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Radiotherapy
  • Retrospective Studies
  • Tertiary Care Centers
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy

Substances

  • Immunosuppressive Agents
  • Methotrexate