Intraocular methotrexate for the treatment of intraocular lymphoma

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Abstract

Purpose. To evaluate the efficacy and toxicity of intravitreal methotrexate in the treatment of intraocular lymphoma. Methods. Three patients with intraocular lymphoma were treated with intravitreal injections of methotrexate (400 micrograms/.1cc). Injections were given twice a week for 4 weeks, once a week for 4 weeks, and then monthly for 1 year. In addition patients with central nervous system lymphoma were treated with blood brain barrier disruption and intra-arterial chemotherapy. Treatment endpoints were a reduction or disappearance of anterior chamber and vitreous cells, and survival. Results. Five eyes of three patients have been treated. No patient has completed the treatment protocol; one patient is three weeks into the protocol, one is 8 weeks into the protocol and one is 12 weeks into the protocol. All treated eyes have had a reduction in the number of vitreous and anterior chamber cells. The principal toxicity has been corneal, with all eyes developing superficial punctate keratitis. Both eyes in one patient developed a filamentary keratitis that responded to topical leucovorin. In this patient the visual acuity in one eye dropped from 20/15 to 20/30, apparently due to the corneal changes. Conclusions. Our early results with intravitreal methotrexate indicate it is reasonably well tolerated and efficacious in treating intraocular lymphoma. It has potential advantages over radiation in that it may have less ocular toxicity, especially in patients that have recurrent disease after previous ocular or central nervous system radiation.

Original languageEnglish (US)
JournalInvestigative Ophthalmology and Visual Science
Volume37
Issue number3
StatePublished - Feb 15 1996

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Intraocular Lymphoma
Methotrexate
Keratitis
Anterior Chamber
Therapeutics
Central Nervous System
Patient Acuity
Radiation
Intravitreal Injections
Leucovorin
Clinical Protocols
Blood-Brain Barrier
Visual Acuity
Lymphoma
Cell Survival
Drug Therapy
Injections

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "Intraocular methotrexate for the treatment of intraocular lymphoma",
abstract = "Purpose. To evaluate the efficacy and toxicity of intravitreal methotrexate in the treatment of intraocular lymphoma. Methods. Three patients with intraocular lymphoma were treated with intravitreal injections of methotrexate (400 micrograms/.1cc). Injections were given twice a week for 4 weeks, once a week for 4 weeks, and then monthly for 1 year. In addition patients with central nervous system lymphoma were treated with blood brain barrier disruption and intra-arterial chemotherapy. Treatment endpoints were a reduction or disappearance of anterior chamber and vitreous cells, and survival. Results. Five eyes of three patients have been treated. No patient has completed the treatment protocol; one patient is three weeks into the protocol, one is 8 weeks into the protocol and one is 12 weeks into the protocol. All treated eyes have had a reduction in the number of vitreous and anterior chamber cells. The principal toxicity has been corneal, with all eyes developing superficial punctate keratitis. Both eyes in one patient developed a filamentary keratitis that responded to topical leucovorin. In this patient the visual acuity in one eye dropped from 20/15 to 20/30, apparently due to the corneal changes. Conclusions. Our early results with intravitreal methotrexate indicate it is reasonably well tolerated and efficacious in treating intraocular lymphoma. It has potential advantages over radiation in that it may have less ocular toxicity, especially in patients that have recurrent disease after previous ocular or central nervous system radiation.",
author = "David Wilson and Rosenbaum, {James (Jim)} and Edward Neuwelt",
year = "1996",
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T1 - Intraocular methotrexate for the treatment of intraocular lymphoma

AU - Wilson, David

AU - Rosenbaum, James (Jim)

AU - Neuwelt, Edward

PY - 1996/2/15

Y1 - 1996/2/15

N2 - Purpose. To evaluate the efficacy and toxicity of intravitreal methotrexate in the treatment of intraocular lymphoma. Methods. Three patients with intraocular lymphoma were treated with intravitreal injections of methotrexate (400 micrograms/.1cc). Injections were given twice a week for 4 weeks, once a week for 4 weeks, and then monthly for 1 year. In addition patients with central nervous system lymphoma were treated with blood brain barrier disruption and intra-arterial chemotherapy. Treatment endpoints were a reduction or disappearance of anterior chamber and vitreous cells, and survival. Results. Five eyes of three patients have been treated. No patient has completed the treatment protocol; one patient is three weeks into the protocol, one is 8 weeks into the protocol and one is 12 weeks into the protocol. All treated eyes have had a reduction in the number of vitreous and anterior chamber cells. The principal toxicity has been corneal, with all eyes developing superficial punctate keratitis. Both eyes in one patient developed a filamentary keratitis that responded to topical leucovorin. In this patient the visual acuity in one eye dropped from 20/15 to 20/30, apparently due to the corneal changes. Conclusions. Our early results with intravitreal methotrexate indicate it is reasonably well tolerated and efficacious in treating intraocular lymphoma. It has potential advantages over radiation in that it may have less ocular toxicity, especially in patients that have recurrent disease after previous ocular or central nervous system radiation.

AB - Purpose. To evaluate the efficacy and toxicity of intravitreal methotrexate in the treatment of intraocular lymphoma. Methods. Three patients with intraocular lymphoma were treated with intravitreal injections of methotrexate (400 micrograms/.1cc). Injections were given twice a week for 4 weeks, once a week for 4 weeks, and then monthly for 1 year. In addition patients with central nervous system lymphoma were treated with blood brain barrier disruption and intra-arterial chemotherapy. Treatment endpoints were a reduction or disappearance of anterior chamber and vitreous cells, and survival. Results. Five eyes of three patients have been treated. No patient has completed the treatment protocol; one patient is three weeks into the protocol, one is 8 weeks into the protocol and one is 12 weeks into the protocol. All treated eyes have had a reduction in the number of vitreous and anterior chamber cells. The principal toxicity has been corneal, with all eyes developing superficial punctate keratitis. Both eyes in one patient developed a filamentary keratitis that responded to topical leucovorin. In this patient the visual acuity in one eye dropped from 20/15 to 20/30, apparently due to the corneal changes. Conclusions. Our early results with intravitreal methotrexate indicate it is reasonably well tolerated and efficacious in treating intraocular lymphoma. It has potential advantages over radiation in that it may have less ocular toxicity, especially in patients that have recurrent disease after previous ocular or central nervous system radiation.

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