Department of Ophthalmology, University of Lübeck, Lübeck, Germany,
Department of Ophthalmology, Ruhr-University, Bochum, Germany.
Neurosignals. 2021 May 5;29(S1):1-7. doi: 10.33594/000000367.
BACKGROUND/AIMS: Intravitreal rituximab is an off-label treatment option for primary vitreoretinal lymphoma (PVRL). The objective of this study was to monitor the therapeutic response and safety profile of intravitreal rituximab in a cohort of PVRL patients.
In this retrospective, uncontrolled, open label, multicentre study, 20 eyes from 15 consecutive patients diagnosed with PRVL received at least one intravitreal injection of 1mg in 0.1ml rituximab. Biodata of the PVRL patients was recorded as well as visual acuity and vitreous haze score immediately before rituximab intravitreal injection and at follow-up examinations. Intravitreal rituximab safety data was also recorded. Additional rituximab injections were made during control visits on a pro re nata (PRN) regime using increased vitreous haze to indicate recurrence.
There was significant vitreous haze reduction (p=0.0002) followed by significant improvement of visual acuity (mean best visual acuity before therapy 0.57 logMAR, after therapy 0.20 logMAR (p=0.0228) during the follow-up time up to 4 years. Only mild ocular side effects were reported. Median follow-up time was 565 days (range, 7-1253 days).
Intravitreal rituximab therapy shows promising PVRL regression without any severe side effects. Although our clinical data support rituximab as intravitreal therapy in PVRL disease, further study is warranted.
背景/目的：玻璃体内利妥昔单抗是原发性玻璃体视网膜淋巴瘤（PVRL）的一种非适应证治疗选择。本研究的目的是监测玻璃体内利妥昔单抗治疗 PVRL 患者的疗效和安全性。
在这项回顾性、非对照、开放标签、多中心研究中，15 例连续确诊为 PRVL 的患者的 20 只眼接受了至少 1mg 利妥昔单抗（0.1ml）的玻璃体内注射。记录了 PRVL 患者的生物数据，以及在玻璃体内利妥昔单抗注射前和随访检查时的视力和玻璃体混浊评分。还记录了玻璃体内利妥昔单抗的安全性数据。在控制访问时，根据需要（PRN）方案增加玻璃体混浊来指示复发，进行额外的利妥昔单抗注射。
玻璃体内混浊显著减少（p=0.0002），随后视力显著改善（治疗前平均最佳视力 0.57 logMAR，治疗后 0.20 logMAR（p=0.0228），随访时间长达 4 年。仅报告了轻微的眼部副作用。中位随访时间为 565 天（范围，7-1253 天）。
玻璃体内利妥昔单抗治疗显示出有希望的 PVRL 消退，没有任何严重的副作用。尽管我们的临床数据支持利妥昔单抗作为 PVRL 疾病的玻璃体内治疗，但仍需要进一步研究。
