John O Mason1, David H Fischer. 1. University of Alabama at Birmingham, Department of Ophthalmology, 35233, USA.
Abstract
PURPOSE: To report the use of intrathecal chemotherapy for two patients with recurrent central nervous system (CNS) intraocular lymphoma. DESIGN: Two interventional case reports. PARTICIPANTS: The clinical course of two patients with documented recurrent CNS intraocular lymphoma were retrospectively reviewed. INTERVENTION: Both patients had previously undergone external beam radiation therapy to the orbit and brain, as well as systemic methotrexate (MTX) and intrathecal cytarabine (Ara-C), for primary CNS intraocular lymphoma. Both patients developed recurrent CNS intraocular lymphoma and treatment involved intrathecal MTX and Ara-C delivered by means of an Ommaya reservoir. MAIN OUTCOME MEASURE: Survival and resolution of intraocular lymphoma. RESULTS: Complete remission of the CNS intraocular lymphoma was seen in both patients. Both patients maintain reading visual acuity in at least one eye. Both patients remain disease free with lymphoma in remission for greater than 5 years after initial diagnosis. CONCLUSIONS: Intrathecal chemotherapy for recurrent CNS intraocular lymphoma seems to be effective in preserving vision and possibly increasing survival.
PURPOSE: To report the use of intrathecal chemotherapy for two patients with recurrent central nervous system (CNS) intraocular lymphoma. DESIGN: Two interventional case reports. PARTICIPANTS: The clinical course of two patients with documented recurrent CNS intraocular lymphoma were retrospectively reviewed. INTERVENTION: Both patients had previously undergone external beam radiation therapy to the orbit and brain, as well as systemic methotrexate (MTX) and intrathecal cytarabine (Ara-C), for primary CNS intraocular lymphoma. Both patients developed recurrent CNS intraocular lymphoma and treatment involved intrathecal MTX and Ara-C delivered by means of an Ommaya reservoir. MAIN OUTCOME MEASURE: Survival and resolution of intraocular lymphoma. RESULTS: Complete remission of the CNS intraocular lymphoma was seen in both patients. Both patients maintain reading visual acuity in at least one eye. Both patients remain disease free with lymphoma in remission for greater than 5 years after initial diagnosis. CONCLUSIONS: Intrathecal chemotherapy for recurrent CNS intraocular lymphoma seems to be effective in preserving vision and possibly increasing survival.
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