Maculopathy as a complication of blood-brain barrier disruption in patients with central nervous system lymphoma.
OBJECTIVE
To report on the development of visually significant maculopathy associated with blood-brain barrier disruption (BBBD) therapy for the treatment of central nervous system (CNS) lymphoma.


METHODS
Retrospective case series.


METHODS
Chart review of 20 patients undergoing BBBD therapy for treatment of CNS lymphoma at the Cleveland Clinic. Patients with documented maculopathy were included in analysis.


RESULTS
Seven (54%) of 13 patients were identified with new macular retinal pigment epithelium (RPE) changes after BBBD treatment. The RPE changes consisted of fine clumps of hyperpigmentation in the foveal region associated with variable degrees of RPE loss. These changes were bilateral but often asymmetric. Two patients had decreased visual acuity resulting from maculopathy. One patient had documented progression of maculopathy after completion of treatment.


CONCLUSIONS
Maculopathy is a frequent finding after BBBD therapy for CNS lymphoma.
Galor
Anat
A
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Ference
Sandra J
SJ
Singh
Arun D
AD
Lee
Michael S
MS
Stevens
Glen H J
GH
Perez
Victor L
VL
Peereboom
David M
DM
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001932:Brain Neoplasms / Q000188:drug therapy*; D002343:Carotid Artery, Internal; D002406:Catheterization, Peripheral; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007278:Injections, Spinal; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects*; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014711:Vertebral Artery
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008353:Mannitol; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate