The trabectome as treatment option in secondary glaucoma due to intraocular lymphoma

J Glaucoma. 2014 Sep;23(7):482-4. doi: 10.1097/IJG.0b013e31827a0875.

Abstract

Primary intraocular lymphoma can cause an elevation of intraocular pressure (IOP), resulting from infiltration of the trabecular meshwork with neoplastic lymphocytes. More rarely, therapeutic procedures can induce a highly synchronised death of tumor cells, leading to congestion of the trabecular meshwork with cell debris. We report on a case of severe IOP elevation after intraocular therapy with methotrexate and rituximab. As medical glaucoma therapy failed, a trabeculotomy with the trabectome was performed, leading to an immediate and sustained decrease in IOP. This novel approach is discussed considering pathogenic aspects of lymphoma-associated glaucoma and alternative surgical techniques.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Female
  • Glaucoma / etiology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Lymphoma / complications*
  • Intraocular Lymphoma / drug therapy
  • Intraocular Lymphoma / pathology
  • Intraocular Pressure
  • Methotrexate / administration & dosage
  • Rituximab
  • Tonometry, Ocular
  • Trabecular Meshwork / surgery*
  • Trabeculectomy / methods*

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • Methotrexate