title: [A case of intraocular lymphoma having retinal adverse events associated with intravitreal methotrexate].
abstract: BACKGROUND
  We report a case of intraocular lymphoma that developed macular edema and cotton wool spots after treatment with intravitreal methotrexate.
  
  
  METHODS
  A 56-year-old woman presented with blurred vision OU. Twelve months prior, she had been diagnosed with primary central nervous system lymphoma. She was in remission after high-dose methotrexate therapy and whole brain radiation therapy. Fundus examination demonstrated bilateral vitreous opacities and subretinal lesions and she was diagnosed with intraocular lymphoma by vitreous biopsy. After treatment with intavitreal methotrexate the subretinal lesions disappeared, but corneal epitheliopathy, macular edema, and cotton wool spots appeared in both eyes. After stopping the intravitreal methotrexate, the corneal epitheliopathy resolved rapidly, but the macular edema and cotton-wool spots remained. These findings disappeared gradually after a posterior sub-Tenon injection of triamcinolone acetonide. Although there was no recurrence of the intraocular lymphoma for 16 months, the patient died from a relapse of the central nervous system lymphoma.
  
  
  CONCLUSIONS
  The use of intravitreal methotrexate after radiation therapy may be associated with adverse events in the retina, including possible radiation retinopathy.
authors.affiliation: Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan. nobuhiro@m3.kufm.kagoshima-u.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kuroiwa
authors.forename: Noriko
authors.initials: N
authors.lastname: Abematsu
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Taiji
authors.initials: T
authors.lastname: Sakamoto
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects*; D005134:Eye Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008223:Lymphoma / Q000188:drug therapy* / Q000532:radiotherapy; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects*; D008875:Middle Aged; D012160:Retina / Q000187:drug effects*
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate