Radiotherapy of primary intraocular lymphoma associated with primary central nervous system lymphoma.

AIM

The aim of the study was to define indications for stereotactic radiotherapy (SRT) of primary intraocular lymphoma (PIOL) and to evaluate the SRT efficacy and toxicity level.

MATERIAL AND METHODS

Twelve immunocompetent patients with PIOL associated with primary CNS lymphoma underwent SRT of the affected eye/both eyes area. Three patients underwent repeated SRT due to PIOL recurrence.

RESULTS

An improvement in visual acuity occurred in 6 patients. No changes in the visual function were observed in patients with high visual acuity, patients with amaurosis, and patients with concomitant eye diseases. Tumoral infiltration of the vitreous body resolved/decreased in all patients, except one case with retinal PIOL. PIOL recurrence developed in 6 patients. The disease-free period ranged from 1 to 24 months. The development/progression of cataract was found in 2 patients. Temporary radiation epidermitis occurred in 7 patients. Three patients developed ocular hypertension. One patient had lower eyelid ectropion.

CONCLUSION

SRT is indicated for PIOL recurrence after intravitreal methotrexate injections, and in the case when local chemotherapy can not be used. In the case of combined injury to the brain and eyes, it is recommended that planned whole brain irradiation to involve the eyeball area. Local SRT is recommended if lymphoma locally affects the eye (or both eyes) without involvement of the brain. PIOL radiotherapy enables achieving persistent local disease control with minimal toxicity manifestations.