Article
Our experiences with diagnosis and treatment of intraocular lymphoma
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Published: | September 22, 2004 |
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Outline
Text
Objective
To evaluate the clinical course of intraocular lymphoma, diagnostic procedures and association between eye and systemic manifestation nonHodgkins lymphoma (NHL) in uveitis patients.
Methods
Retrospective study of 14 patients who were observed between 1997 and 2003 in the Centre of Diagnosis and Treatment of Uveitis, Department of Ophthalmology, 1st Medical Faculty, Charles University, Prague.
Results
There were 7 women and 7 men with clinical features of uveitis in our investigated group. Mean age of the patients was 57.3 years (18-82). Time between first eye problems and NHL diagnosis was 5-38 months (mean 14.6 months). NHL was diagnosed before eye manifestation of disease in 2 patients, diagnosis NHL was diagnosed in same time when eye manifestation was present in 4 patients. NHL was only first symptom of CNS NHL in six patients during 9-34 months (mean 15.2 months). Two patients have within observing period (8 and 14 months) primary intraocular lymphoma, until today without system or CNS involvement. Clinical features of intraocular inflammation had 71.4% patients. We found vitritis and tumorous retinal infiltration in 85.7% and 65.3% patients respectively as the most common clinical features of NHL. Diagnosis of NHL was basing on cytological examination of vitreous samples in 8 patients (57.1%). 4 patients underwent radiotherapy of the eyes and 5 patients radiotherapy of CNS. 9 patients underwent chemotherapy. 50% patients died up to year 2001. Mean time from diagnosis to death was 20.6 months.
Conclusions
NHL is sight threatened and life threatened disease. Cytological examination of vitreous samples could precise and shorten diagnosis of this masquerade syndrome in uveitis patients with non-standard clinical course and non-reacting to treatment. Prompt diagnosis can improve prognosis NHL.