Intraocular lymphoma: a series of 14 patients with clinicopathological features and treatment outcomes

Eye (Lond). 2003 May;17(4):513-21. doi: 10.1038/sj.eye.6700378.


Aims: To assess the clinical features, pathology, mortality (systemic outcome) and ocular complications (visual outcome) of a cohort of patients treated for intraocular lymphoma.

Methods: Retrospective case analysis of medical records and review of pathology of a consecutive series of patients presenting with intraocular lymphoma in Melbourne over 11 years between 1990 and 2000. Categorical factors influencing survival were examined by the Kaplan-Meier estimator and groups compared with the log rank test.

Results: A total of 14 patients were included. The median age of onset of symptoms was 62.5 years. Most were male (64%) and had bilateral eye involvement (64%). The commonest presentation was vitritis in 12 patients, with a median delay of 4 months before diagnosis. In all, 10 patients had B-cell lymphoma, three patients T-cell lymphoma and one null-cell. Four patients had prior systemic lymphoma. Eight patients had primary central nervous system non-Hodgkin's lymphoma (PCNSL). Treatment included combined radiation to the eye and chemotherapy in 10 patients. Complications of radiotherapy included cataract in five (50%), dry eyes in four (40%), punctate keratopathy in two (20%), radiation retinopathy in two (20%), and optic atrophy in one (10%). A total of 11 patients died of lymphoma (79%). One has residual ocular disease, while two have survived for more than 5 years from initial presentation. Although currently disease free, one of these has a poor visual outcome with acuity less than 6/60 secondary to ocular complications of treatment.

Conclusions: Our study had 29% with prior systemic lymphoma, 57% associated with PCNSL and 14% with intraocular disease only. Overall survival is low (21%) and relapses common in those surviving beyond 12 months. Visual outcome in survivors is very poor due, in large part, to significant complications from radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Eye Neoplasms / diagnosis
  • Eye Neoplasms / pathology*
  • Eye Neoplasms / therapy
  • Female
  • Humans
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Prognosis
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Vision Disorders / etiology