title: EXTERNAL BEAM RADIATION FOR CHOROIDAL LYMPHOMA: Efficacy and Complications.
abstract: OBJECTIVE
  To determine the efficacy and safety of external beam radiation for treatment of choroidal lymphoma (CL).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Twenty-five eyes of 24 patients with CL treated with external beam radiation.
  
  
  METHODS
  Review of medical records.
  
  
  METHODS
  Tumor control, visual acuity, and radiation complications.
  
  
  RESULTS
  The mean age of the patients was 62 years (median, 65; range, 32-89 years). Only 2 patients (8%) had a history of systemic lymphoma. The most common symptom was painless blurred vision in 14 eyes (58%) and the mean duration of ocular symptoms was 12 months (median, 7; range, 1-36 months). Initial best-corrected visual acuity was 20/40 or better in 10 eyes (40%), 20/50 to 20/150 in 12 eyes (48%), and 20/200 or less in the other 3 eyes (12%). The fovea was involved by the CL in 16 eyes (64%). Mean tumor thickness was 3.1 mm (median, 3.0; range 1.1-6.3 mm). Anterior and posterior transscleral extension of CL were present in 15 (60%) and 14 eyes (56%), respectively. All patients, except 3 (13%), had some form of ocular biopsy confirming the diagnosis of ocular lymphoma. The mean total radiation dose was 2,867 cGy (median, 3,000; range, 1,200-3,600 cGy). At final examination, after a mean follow-up period of 58 months (median, 35; range, 13-228 months), 18 eyes (72%) showed complete regression of CL and 7 eyes (28%) showed partial regression. All eyes (100%) with initial serous retinal detachment (14 eyes), subfoveal fluid (8 eyes), and macular edema (5 eyes) achieved complete resolution of subretinal or intraretinal fluid after treatment. Recurrence of CL after initial partial response developed in only 1 eye (4%). Compared with the initial evaluation, final best-corrected visual acuity had increased in 11 (44%), was stable in 8 (32%), and had decreased in 6 eyes (24%). Only 2 eyes (8%) showed signs of mild nonproliferative retinopathy.
  
  
  CONCLUSIONS
  In this study, external beam radiation was an effective and safe modality for treatment of CL, achieving long-term tumor regression in 96% and stable or improved vision in 76% after mean follow-up period of 6 years.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Arman
authors.initials: A
authors.lastname: Mashayekhi
authors.forename: Murat
authors.initials: M
authors.lastname: Hasanreisoglu
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008269:Macular Edema / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D061766:Proton Therapy; D011879:Radiotherapy Dosage; D012163:Retinal Detachment / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology