title: Maculopathy as a complication of blood-brain barrier disruption in patients with central nervous system lymphoma.
abstract: 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.
authors.affiliation: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Ference
authors.forename: Arun D
authors.initials: AD
authors.lastname: Singh
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Glen H J
authors.initials: GH
authors.lastname: Stevens
authors.forename: Victor L
authors.initials: VL
authors.lastname: Perez
authors.forename: David M
authors.initials: DM
authors.lastname: Peereboom
mesh_terms: 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
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008353:Mannitol; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate