Velez Gisela, Boldt H Culver, Whitcup Scott M, Nussenblatt Robert B, Robinson Michael R
Laboratory of Immunology, National Eye Institute, NIH, USA.
Ophthalmic Surg Lasers. 2002 Jul-Aug;33(4):329-33.
A 70-year-old patient with recurrent bilateral primary intraocular lymphoma (PIOL) was treated with local injections of methotrexate and periocular dexamethasone phosphate to both eyes over the course of 5 months. Local therapy consisted of a cycle to each eye of 3 intravitreal injections of methotrexate (200 microg in a total volume of 0.1 cc) administered on days 1, 5, and 8, followed by a subtenon injection of dexamethasone phosphate (7.5 mg in a total volume of 0.3 cc) on day 9. This treatment cycle was administered 4 times for the right eye and 3 times for the left eye, at 4 to 6 week intervals. Electroretinography was used to assess retinal function prior to and during each treatment regimen. Complete regression of the lymphomatous infiltrates and resolution of the vitritis was observed with preservation of visual acuity and no changes on electroretinography. The effect was sustained for 24 months after termination of treatment in the absence of systemic chemotherapy, radiation treatments, or maintenance intravitreal injections. Local combined chemotherapy can be used to treat recurrent PIOL, and can serve as successful palliative therapy in patients for whom further treatment with systemic chemotherapy or radiation is contraindicated.
一名70岁复发性双侧原发性眼内淋巴瘤（PIOL）患者在5个月内接受了双眼局部注射甲氨蝶呤和眼周地塞米松磷酸钠治疗。局部治疗包括每只眼睛一个疗程，在第1、5和8天进行3次玻璃体内注射甲氨蝶呤（总量200微克，总体积0.1毫升），然后在第9天进行一次球后注射地塞米松磷酸钠（总量7.5毫克，总体积0.3毫升）。此治疗周期右眼进行4次，左眼进行3次，间隔4至6周。在每个治疗方案之前和期间使用视网膜电图评估视网膜功能。观察到淋巴瘤浸润完全消退，葡萄膜炎消退，视力得以保留，视网膜电图无变化。在未进行全身化疗、放疗或维持性玻璃体内注射的情况下，治疗终止后效果持续了24个月。局部联合化疗可用于治疗复发性PIOL，对于禁忌进一步进行全身化疗或放疗的患者可作为成功的姑息治疗方法。
