title: Resolution of lymphoma-associated open-angle glaucoma by rituximab.
abstract: OBJECTIVE
  To report a patient who developed open-angle glaucoma, secondary to bilateral perilimbal conjunctival lymphoid infiltrates without intraocular involvement that resolved after treatment with systemic rituximab.
  
  
  METHODS
  Observational case report.
  
  
  RESULTS
  Review of historic, clinical, and photographic data of a 67-year-old woman with non-Hodgkin lymphoma of the axillary and cervical lymph nodes and bilateral perilimbal conjunctival lymphoid infiltrates who presented for treatment of uncontrolled chronic open-angle glaucoma on maximum medical therapy. The elevated intraocular pressures and conjunctival lesions resolved after treatment of the systemic lymphoma with rituximab. The patient was followed for a period of 6 years without recurrence of the conjunctival lesions, with low normal intraocular pressures without progressive optic nerve damage off all glaucoma treatments.
  
  
  CONCLUSIONS
  Open-angle glaucoma can result as a consequence of isolated conjunctival lymphoid tumors and can resolve with successful treatment of lymphoid lesions. The mechanism of glaucoma may be obstruction of aqueous outflow to the episcleral and conjunctival veins either by compression from a mass effect or direct infiltration that is relieved with resolution of the conjunctival lymphoid lesions. We believe this is a unique presentation of glaucoma associated with lymphoid tumors that has not been reported earlier.
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA. won.kim1@us.army.mil
authors.forename: Won I
authors.initials: WI
authors.lastname: Kim
authors.forename: Jeanette G
authors.initials: JG
authors.lastname: Larar
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Cheson
authors.forename: Richard K
authors.initials: RK
authors.lastname: Lee
authors.forename: Paul F
authors.initials: PF
authors.lastname: Palmberg
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003230:Conjunctival Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure; D008207:Lymphatic Metastasis; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy*; D000069283:Rituximab; D014065:Tonometry, Ocular; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab