What is the role of ocular therapy in the treatment of primary central nervous system lymphoma (PCNSL)?

Updated: Jan 19, 2018
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

In a retrospective study of 221 patients with brain and ocular lymphoma, Grimm et al found that dedicated ocular therapy improved disease control but did not affect overall survival. The patients in the study were HIV-negative and immunocompetent, and none had systemic lymphoma. [17]

In phakic intraocular lenses (PIOL), vitrectomy improves vision by eliminating opacities formed by cellular clumps and debris in the vitreous cavity. Because of the high incidence of bilateral disease, ocular external-beam radiotherapy is recommended for both eyes. The trend is now toward using systemic chemotherapy for PIOL. If refractory or recurrent intraocular disease is encountered, additional systemic/intrathecal chemotherapy with adjunctive intravitreal methotrexate is administered. PIOL remains an aggressive disease with an overall 5-year survival rate of less than 25%.


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