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Type presentatieE-poster
TitelPositive Response to Intravitreal Methotrexate Combined with Vitrectomy in Two Patients with Primary Intraocular Lymphoma
DoelPrimary intraocular lymphoma (PIOL) possesses significant therapeutic challenges due to its aggressive nature and potential for central nervous system dissemination. This case series aims to report the clinical outcomes of two patients diagnosed with PIOL, who demonstrated significant ocular improvement following pars plana vitrectomy with peripheral shaving with subsequent intravitreal methotrexate administrations.
MethodesTwo patients, aged 81 (bilateral PIOL) and 73 (unilateral PIOL), presented with blurred vision and floaters, without any significant ocular discomfort. Ophthalmic examination revealed vitreous haze with big cells and a mottled aspect of the retina with diffuse retinal infiltrates. A diagnosis of Diffuse Large B-Cell Lymphoma was confirmed via vitrectomy with biopsy in the first patient, while it could not be confirmed in the second patient. Central involvement was ruled out with MRI scan of the brain. Both patients were treated with intravitreal methotrexate injections (400 μg/0.1 mL) firstly during the operation and administered weekly for 4 weeks after. Clinical responses were evaluated through visual acuity, anterior and posterior segment examinations and OCT imaging.
ResultatenBoth patients demonstrated a significant reduction in vitreous haze and retinal infiltrates and showed marked improvement in ocular symptoms and vision after treatment. OCT confirmed the reduction in retinal infiltrates and macular edema in both cases.
ConclusieBy combining a vitrectomy with the first dose of methotrexate, you have the immediate advantage of clearing up the vitreous debris to improve the vision faster. However, obtaining a good vitreous sample remains challenging despite having performed a complete pars plana vitrectomy over a core vitrectomy.
BelangenverstrengelingNee
Auteurs 1
NaamKOULALIS
InitialenJ
InstituutUZ Brussel
StadJette
Auteurs 2
NaamPieter-Paul Schauwvlieghe
InitialenPP
InstituutZAS Cadix
StadAntwerpen
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