scholarly journals Primary Vitreoretinal Lymphoma Therapy Monitoring: Significant Vitreous Haze Reduction After Intravitreal Rituximab

Neurosignals ◽  
2021 ◽  
Vol 29 (S1) ◽  
pp. 1-7
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Intravitreal Injection ◽  
Therapy Monitoring ◽  
Safety Data ◽  
Intravitreal Therapy ◽  
Primary Vitreoretinal Lymphoma ◽  
Vitreoretinal Lymphoma ◽  
Vitreous Haze

BACKGROUND/AIMS: Intravitreal rituximab is an off-label treatment option for primary vitreoretinal lymphoma (PVRL). The objective of this study was to monitor the therapeutic response and safety profile of intravitreal rituximab in a cohort of PVRL patients. METHODS: In this retrospective, uncontrolled, open label, multicentre study, 20 eyes from 15 consecutive patients diagnosed with PRVL received at least one intravitreal injection of 1mg in 0.1ml rituximab. Biodata of the PVRL patients was recorded as well as visual acuity and vitreous haze score immediately before rituximab intravitreal injection and at follow-up examinations. Intravitreal rituximab safety data was also recorded. Additional rituximab injections were made during control visits on a pro re nata (PRN) regime using increased vitreous haze to indicate recurrence. RESULTS: There was significant vitreous haze reduction (p=0.0002) followed by significant improvement of visual acuity (mean best visual acuity before therapy 0.57 logMAR, after therapy 0.20 logMAR (p=0.0228) during the follow-up time up to 4 years. Only mild ocular side effects were reported. Median follow-up time was 565 days (range, 7-1253 days). CONCLUSION: Intravitreal rituximab therapy shows promising PVRL regression without any severe side effects. Although our clinical data support rituximab as intravitreal therapy in PVRL disease, further study is warranted.

scholarly journals Clinical outcomes following intravitreal methotrexate for primary vitreoretinal lymphoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Casey L. Anthony ◽  
J. Clay Bavinger ◽  
Jessica G. Shantha ◽  
Ghazala D. O’Keefe ◽  
William A. Pearce ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Systemic Chemotherapy ◽  
Cns Lymphoma ◽  
Primary Vitreoretinal Lymphoma ◽  
Vitreoretinal Lymphoma ◽  
Intravitreal Treatment ◽  
The Mean ◽  
Mean Time

Abstract Purpose To describe the visual acuity and anatomic outcomes of intravitreal methotrexate (MTX) for the treatment of primary vitreoretinal lymphoma (PVRL). Methods Single-center retrospective case series of patients with a diagnosis of PVRL treated with intravitreal MTX. Patient records were reviewed for demographic information, ocular exam findings, and treatment regimens including number of MTX injections. Clinical outcomes recorded included visual acuity (VA), time to partial (PR) or complete response (CR), disease-free survival, time to relapse, and any CNS progression. Results Ten eyes of 7 patients (4 male, 6 female) were reviewed. The mean age ± standard deviation (SD) was 70 ± 12 years. Five patients had prior or concomitant diagnosis of primary CNS lymphoma with a history of systemic chemotherapy including MTX. Three eyes (30%) exhibited isolated vitreous involvement, four (40%) had subretinal lesions, and three (30%) presented with both vitreous and subretinal disease. Mean initial logMAR VA was 0.38 ± 0.52 (Snellen visual equivalent 20/50), while mean final logMAR VA ± SD was 0.34 ± 0.27 (Snellen visual equivalent 20/40) with a mean follow-up time of 26 months (Range, 3–49 months). Patients received an average of 6 intravitreal MTX injections (Range 1–10) over the course of treatment. Two patients received concomitant systemic chemotherapy. Mean time to either PR or CR was 57 days, and 6 eyes (60%) exhibited regression with no relapse after local treatment. For the 4 eyes that eventually relapsed, the mean time ± SD to first relapse was 193 days ± 155 days, and one eye experienced a second relapse. Two of 3 patients with subretinal disease showed complete regression with extended follow-up of 1 and 4 years following treatment with less than 3 doses of intravitreal MTX. One patient with PVRL developed CNS lymphoma during the study period. VA remained stable overall between the initial treatment visit, 3, 6, and 12-months (P > 0.05 for paired comparisons of VA over time). Conclusions Intravitreal methotrexate was well-tolerated and led to local disease response in the majority of patients at approximately 2 months after initiation of treatment of intraocular lymphoma. Further studies on the efficacy of intravitreal treatment alone versus combined systemic and intravitreal treatment are warranted.

Branch Retinal Artery Occlusion Following Intravitreal Injection of Methotrexate for the Treatment of Primary Vitreoretinal Lymphoma

2019 ◽  
Vol 3 (6) ◽  
pp. 485-487
Author(s):  
Arthi G. Venkat ◽  
Naveen Karthik ◽  
Ashley Lowe ◽  
Sumit Sharma
Keyword(s):  
Intravitreal Injection ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Primary Vitreoretinal Lymphoma ◽  
Case Summary ◽  
Vitreoretinal Lymphoma ◽  
Retinal Artery ◽  
Vitreous Biopsy ◽  
Rule Out

Purpose: This paper reports a case of an older white woman presenting with recalcitrant bilateral vitreoretinal inflammation that was ultimately proven to be primary vitreoretinal lymphoma by vitreous biopsy who subsequently developed a branch retinal artery occlusion (BRAO) following an intravitreal injection of methotrexate. Methods: Case summary. Results: The patient was treated with serial intravitreal methotrexate injections and subsequently developed a BRAO immediately following her seventh injection. Conclusions: A full systemic evaluation to rule out other causes of the BRAO was negative and given the timing of her symptoms after the injection it was determined that the BRAO was most likely realted to the intravitreal methotrexate injection.

Intravitreal topotecan in the management of refractory and recurrent vitreous seeds in retinoblastoma

2017 ◽  
Vol 102 (4) ◽  
pp. 490-495 ◽  
Author(s):  
Raksha Rao ◽  
Santosh G Honavar ◽  
Vishal Sharma ◽  
Vijay Anand P Reddy
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Primary Treatment ◽  
Complete Regression ◽  
Intravenous Chemotherapy ◽  
Systemic Complications ◽  
Group D ◽  
Vitreous Seeds

Background/aimTo evaluate the efficacy of intravitreal topotecan for refractory or recurrent vitreous seeds in retinoblastoma.MethodsIntravitreal injection of topotecan hydrochloride (30 µg/0.15 mL) was provided every 3 weeks by the safety enhanced technique.ResultsThe study included 17 consecutive patients with retinoblastoma with refractory or recurrent vitreous seeds. Five eyes (29%) belonged to International Classification of Retinoblastoma group C and 12 eyes (71%) belonged to group D. Primary treatment included triple drug intravenous chemotherapy for a mean of 10 cycles (median, 9 cycles; range, 6–18 cycles). Fifteen patients (88%) had undergone 56 periocular carboplatin injections with a mean of 4 injections (median, 3 injections; range, 1–8 injections), concurrent with intravenous chemotherapy. A total of 53 intravitreal topotecan injections were performed in 17 eyes of 17 consecutive patients with refractory or recurrent vitreous seeds with a mean of 3 injections (median, 3 injections; range, 2–6 injections). Complete regression of vitreous seeds was achieved in 17 of 17 eyes (100%). At a mean follow-up of 23.8 months (median, 24 months; range, 15.1–34.1 months), one eye (6%) with a recurrent retinal tumour needed enucleation, and the rest of the 16 eyes (94%) maintained complete regression. Final visual acuity could be reliably assessed in all 16 eyes (100%), of whom 12 eyes (75%) had visual acuity ≥20/200. None of the patients developed ocular or systemic complications.ConclusionThree-weekly intravitreal topotecan appears effective and safe in controlling focal or diffuse refractory or recurrent vitreous seeds in retinoblastoma.

Ibopamine Treatment in Chronic Hypotony Secondary to Long-Lasting Uveitis. A Case Report

2000 ◽  
Vol 10 (4) ◽  
pp. 332-334 ◽  
Author(s):  
P. Pivetti-Pezzi ◽  
S. Da Dalt ◽  
M. La Cava ◽  
M. Pinca ◽  
F. De Gregorio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Side Effects ◽  
Visual Field ◽  
Clinical Efficacy ◽  
Eye Drops ◽  
Days Of Therapy ◽  
History Of

Purpose To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. Methods Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl®) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. Results IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS®) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. Conclusions Ibopamine 2% eye drops in BSS® solvent seem effective in the treatment of uveitis-related hypotony.

scholarly journals Lenalidomide and Rituximab Regimen Combined With Intravitreal Methotrexate Followed by Lenalidomide Maintenance for Primary Vitreoretinal Lymphoma: A Prospective Phase II Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yan Zhang ◽  
Xiao Zhang ◽  
Dongmei Zou ◽  
Jingjing Yin ◽  
Li Zhang ◽  
...  
Keyword(s):  
Treatment Options ◽  
Progression Free Survival ◽  
Common Adverse Event ◽  
Cns Lymphoma ◽  
Primary Vitreoretinal Lymphoma ◽  
Single Center Study ◽  
Vitreoretinal Lymphoma ◽  
Prospective Phase ◽  
Grade 3

Primary vitreoretinal lymphoma (PVRL) is a rare variant of primary central nervous system (CNS) lymphoma, for which currently there are no optimal treatment options. This prospective single-center study enrolled immunocompetent patients with newly diagnosed PVRL between August 2018 and January 2020. Patients received local and systemic therapies: intravitreal methotrexate (MTX, 400 μg, 0.1 mL) injections for 1 year (total 16 injections) and six cycles of the rituximab (375 mg/m2 on day 1) and lenalidomide (25 mg on day 1–21; R2) regimen. Lenalidomide was maintained for 2 years in patients who had achieved a response. We enrolled 11 patients with a mean age of 58 (range, 48–70) years, of which 10 achieved complete remission at the first evaluation. The median follow-up period was 18.3 (range, 10.6–27.8) months, and the median progression-free survival was 12.7 months. Moreover, a total of eight patients relapsed. The most common adverse event (AE) was neutropenia, which occurred in seven patients (63.6%), followed by grade 3 ocular toxicities, including cataract formation, in six patients (54%). These findings suggest that the R2 regimen combined with intravitreal MTX, followed by lenalidomide maintenance, is a safe option for PVRL with moderate efficacy. This trial is registered with ClinicalTrials.gov (number NCT 03746223).

scholarly journals Serial changes in the aqueous IL-10 level after intravitreal methotrexate injection as an indicator of primary vitreoretinal lymphoma recurrence

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Young Gun Park ◽  
Woo-Kyung Park ◽  
Rae-Young Kim ◽  
Mirinae Kim ◽  
Young-Hoon Park
Keyword(s):  
Case Series ◽  
Disease Recurrence ◽  
Rapid Reduction ◽  
Primary Vitreoretinal Lymphoma ◽  
Case Series Study ◽  
Tnf Α ◽  
Vitreoretinal Lymphoma ◽  
Series Study ◽  
Necrosis Factor

Abstract Primary vitreoretinal lymphoma (PVRL) often masquerades as other uveitic diseases. We investigated the aqueous cytokine level changes and the effects of intraocular methotrexate (MTX) in patients with PVRL. In this retrospective consecutive case-series study, we reviewed the records of 14 consecutive patients with PVRL treated between 2018 and 2020. The concentrations of interleukin (IL)-2, IL-6, IL-10, IL-12, IL-17, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were determined at baseline and several time points after intravitreal MTX injections during follow-up. Markedly elevated IL-10 levels and a higher IL-10/IL-6 ratio were found in patients with PVRL. The aqueous levels of IL-10, IL-12, and TNF-α, and the IL-10/IL-6 ratio significantly decreased at 1 month after intravitreal MTX therapy onset compared with the baseline values (P = 0.001, 0.002, 0.001, and 0.001, respectively). The mean duration to normalized IL-10 levels was 1.17 ± 0.4 months. Where serially recorded IL-10 levels were available, regular intravitreal MTX treatment was associated with rapid reduction in IL-10 levels, while elevated IL-10 level was associated with disease recurrence. Elevated IL-10 levels and high IL-10/IL-6 ratio may aid in the diagnosis of PVRL. Aqueous IL-10 level monitoring can help assess the therapeutic response and indicate disease recurrence.

scholarly journals Diabetic macular edema: Safe and effective treatment with intravitreal triamcinolone acetonide (Taioftal)

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257695
Author(s):  
Francesco Saverio Sorrentino ◽  
Claudio Bonifazzi ◽  
Francesco Parmeggiani
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Foveal Thickness ◽  
Intravitreal Triamcinolone ◽  
Central Foveal Thickness ◽  
Preservative Free

Purpose To suggest the safety and efficacy of preservative-free triamcinolone acetonide intravitreal injectable suspension (Taioftal) for the treatment of diabetic macular edema. Methods A prospective clinical study involved 49 patients (49 eyes), that were treated with Taioftal and followed-up for six months. Complete ophthalmic examination, including spectral domain optical coherence tomography, was performed at baseline, and at month 1, 3, 6 after the intravitreal injection. Accurate collection and analysis of best-corrected visual acuity (BCVA), central foveal thickness (CFT), intraocular pressure (IOP), and adverse events (AEs) were carried out in order to evaluate visual function and macular morphology before and after treatment Results Median BCVA value chosen as comparing statistics was significantly improved at every follow-up time points (gain of 6 letters at month 1, 12 at month 3 –improvement up to 24% at month 3 with stabilization until month 6) compared to baseline, as certified by Kruskal-Wallis rank sum test (P<0.05). Median CFT significantly waned at each follow-up times (decrease of about 65 μm at month 1, 155 at month 3 –reduction up to 28% at month 3 keeping good outcome until month 6) compared to baseline (P<0.05). IOP elevation, with no severe increases, was the most common among spotted AEs (median of 23 mmHg at month 1, 20 at month 3). Conclusion Intravitreal injection of preservative-free triamcinolone (Taioftal) is an effective, safe and inexpensive drug used to improve visual acuity and reduce central foveal thickness in eyes affected by diabetic macular edema during an average time of 6 months. Temporary, never severe, elevation of IOP is totally manageable with topical medications. No serious vision-threatening complications are related to the use of intravitreal triamcinolone injections.

scholarly journals Intravitreal moxifloxacin in acute post-phacoemulsification endophthalmitis: a case report

2021 ◽  
Vol 3 (4) ◽  
pp. 236-243
Author(s):  
Tri Winarti ◽  
Mohammad Eko Prayogo ◽  
Suhardjo Pawiroranu ◽  
Rifna Luthfiamida ◽  
Grace Sancoyo
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Therapeutic Dose ◽  
Hand Movement ◽  
Oral Antibiotics ◽  
Broad Spectrum Antibiotic ◽  
Blurred Vision ◽  
Vitreous Opacities ◽  
The Right

Background: Vancomycin and ceftazidime are commonly used intravitreal antibiotics to treat acute post-phacoemulsification endophthalmitis. However, they are not commercially available in appropriate therapeutic dose for intravitreal injection. Moxifloxacin is a broad-spectrum antibiotic that is commercially available in appropriate therapeutic dose for intravitreal injection, thus providing a rationale for its use in acute post-phacoemulsification endophthalmitis.Case presentation: A 46-year-old female presented with blurred vision, redness, and pain in the right eye 5 days after phacoemulsification. Visual acuity was hand movement and conjunctival and circumcorneal injection, corneal oedema, anterior chamber reaction, and vitreous opacities were observed. The patient was treated with intravitreal moxifloxacin 500 μg/0.1 ml, vitrectomy, and topical and oral antibiotics. Visual acuity improved to 6/15 and follow-up at 5 weeks did not reveal any signs of intraocular inflammation.Conclusion: Intravitreal moxifloxacin is an alternative in the treatment of acute post-phacoemulsification endophthalmitis.

scholarly journals Predictors of Visual Recovery in Patients with Macular Edema Secondary to Central Retinal Occlusion After Treatment with Conbercept

2021 ◽  
Author(s):  
Qi Zhang ◽  
Yinfen Hou ◽  
Xiao Cao ◽  
Rongrong Zhang ◽  
Yinping Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Layer Thickness ◽  
Outer Nuclear Layer ◽  
Post Treatment ◽  
Photoreceptor Layer ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background The use of Spectral domain optical coherence tomography (SD-OCT) to evaluate the predictors of visual acuity-recovery in patients treated with conbercept for macular edema (ME) secondary to central retinal vein occlusion (CRVO) has rarely been seen.We collected 24 CRVO-ME patients with different OCT measures at 6 months follow-up to identify the factors that are most strongly correlated with the best-corrected visual acuity (BCVA) post-treatment in CRVO-ME patients treated with conbercept Purpose To evaluate the effectiveness of intravitreal conbercept injections for the treatment of CRVO-ME and to determine the major predictors of best-corrected visual acuity (BCVA) post-treatment. Methods A retrospective study methodology was used. Twenty-four eyes from 24 patients with CRVO-ME were enrolled in the study. After an initial intravitreal injection of conbercept (0.5 mg/0.05 ml), monthly injections for up to 6 months were given following a 1 + PRN (pro re nata) regimen. Data collected at monthly intervals included measurements of the logMAR BCVA, central subfield thickness (CST), macular volume (MV), photoreceptor layer thickness (PLT), outer nuclear layer thickness (ONLT), and the disrupted ellipsoid zone (DEZ). The correlation between BCVA, before and after injections, and each of CST, MV, PLT, ONLT, DEZ was analyzed. Results The logMAR BCVA in months 3 and 6 post-injection was significantly improved relative to the baseline. In this same period the CST, MV, PLT, ONLT and DEZ were also significantly improved relative to the baseline. There was a negative correlation between PLT and logMAR BCVA at months 3 and 6 (r = -0.549, P < 0.001; r = -0.087, P < 0.001). Conclusion Intravitreal injection of conbercept is an effective treatment for CRVO-ME. With six months of follow-up, logMAR BCVA and CST, MV, PLT, ONLT, DEZ improved. PLT was negatively correlated with the visual function in CRVO-ME patients after conbercept treatment, which may be a predictor of vision recovery in patients with CRVO-ME.

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