Management of non Hodgkin's intraocular lymphoma with intravitreal methotrexate.
Intraocular non Hodgkin's lymphoma has traditionally been treated with radiotherapy or systemic chemotherapeutic agents. Unfortunately, radiotherapy rarely leads to a long term remission, and can only be safely administered once. Systemic chemotherapy has limited intraocular penetration. Intravitreal administered methotrexate is highly effective at inducing remission and is well tolerated. A case report is presented of a recurrent intraocular lymphoma following radiotherapy and systemic chemotherapy which responded to a combination of intravitreal methotrexate and dexamethasone. A response was seen within three weeks of treatment initiation. Toxicity was limited to the progression of a pre-existing cataract. Review of the literature shows that intravitreal methotrexate is well tolerated, with few acute complications. However, with monotherapy, local recurrences have been observed.
de Smet
M D
MD
Department of Ophthalmology, University of Amsterdam, Amsterdam. m.d.desmet@amc.uva.nl
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005134:Eye Neoplasms / Q000188:drug therapy*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012074:Remission Induction; D014822:Vitreous Body
D003907:Dexamethasone; D008727:Methotrexate