Resolution of lymphoma-associated open-angle glaucoma by rituximab.
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.
Kim
Won I
WI
Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA. won.kim1@us.army.mil
Larar
Jeanette G
JG
Cheson
Bruce D
BD
Lee
Richard K
RK
Palmberg
Paul F
PF
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
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab