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Intravitreal rituximab monotherapy for management of eyes with vitreoretinal lymphoma: initial experience from India

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Abstract

Purpose

To evaluate treatment outcomes and complications of intravitreal rituximab (IVR) monotherapy for eyes with vitreoretinal lymphoma (VRL).

Methods

Patients diagnosed with ‘isolated primary VRL’ or ‘VRL with remission of systemic disease’ and treated with IVR (1 mg/0.1 ml) between June 2014 and June 2019 were included in this retrospective, interventional case series. Injections were repeated at monthly intervals until complete resolution. All patients signed a written informed consent form. Institutional review board approval was obtained.

Results

Twelve eyes of 7 patients with VRL were treated with 77 IVR injections at mean 6.42 injections per eye (median = 5; range = 2–13) for complete resolution at mean 8.16 ± 4.62 months (median = 6.97 months; range = 1.97–14.33 months). Mean age at presentation was 53.3 years (median = 54 years; range = 34–74 years). Patients were co-managed with medical oncologist and periodically evaluated. Complications included anterior uveitis (n = 6), raised intraocular pressure (n = 3), posterior synechiae (n = 2), vitreous haemorrhage (n = 1), pre-retinal haemorrhage (n = 1), retinal detachment (n = 1), posterior subcapsular cataract (n = 2) and sectoral iris atrophy (n = 1). Recurrences were seen in 3 eyes (25%), which eventually achieved complete resolution with treatment. None of the patients had systemic involvement or death during follow-up. Mean follow-up was 18.73 ± 8.83 months (median = 21.60 months; range = 7.37–32.67 months).

Conclusion

Intravitreal rituximab monotherapy is effective in management of vitreoretinal lymphoma in patients with isolated ocular disease.

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Fig. 1
Fig. 2
Fig. 3

source OCT shows typical sub-RPE localization of lymphoma with dome-shaped RPE elevation(white arrow) (c; ‘lumpy-bumpy tumour surface’)

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Funding

This study is not financially supported.

Author information

Authors and Affiliations

  1. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, 600006, India

    Pukhraj Rishi, Pradeep T. Manchegowda, Harshal P. Gondhale, Ekta Rishi & Kalpita Das

  2. L&T Ocular Pathology Department, Medical Research Foundation, 18 College Road, Chennai, Tamilnadu, 600006, India

    Subramanian Krishnakumar & Jyotirmay Biswas

  3. Apollo Speciality Hospitals, 8 Cenotaph Road, Rathna Nagar Alwarpet, Chennai, Tamil Nadu, 600018, India

    Thirumalairaj Raja

Authors
  1. Pukhraj Rishi
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  2. Pradeep T. Manchegowda
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  3. Harshal P. Gondhale
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  4. Ekta Rishi
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  5. Kalpita Das
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  6. Subramanian Krishnakumar
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  7. Thirumalairaj Raja
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  8. Jyotirmay Biswas
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Contributions

Pukhraj Rishi was involved in conceptualization. Pukhraj Rishi performed methodology. Pukhraj Rishi, Pradeep T Manchegowda and Harshal P Gondhale contributed to formal analysis and investigation. Pradeep T Manchegowda prepared writing—original draft. Pukhraj Rishi, Pradeep T Manchegowda, Ekta Rishi, Kalpita Das, Subramanian Krishnakumar, Thirumalairaj Raja and Jyotirmay Biswas were all involved in writing—review and editing.

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Correspondence to Pukhraj Rishi.

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Informed consent was obtained from all study participants.

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Rishi, P., Manchegowda, P.T., Gondhale, H.P. et al. Intravitreal rituximab monotherapy for management of eyes with vitreoretinal lymphoma: initial experience from India. Int Ophthalmol 41, 2495–2504 (2021). https://doi.org/10.1007/s10792-021-01805-1

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  • DOI: https://doi.org/10.1007/s10792-021-01805-1

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