Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma.
Antineoplastic Agents
/ adverse effects
Blood-Retinal Barrier
/ drug effects
Brain Neoplasms
/ complications
Female
Fluorescein Angiography
/ methods
Fundus Oculi
Humans
Incidence
Lymphoma
/ complications
Lymphoma, Large B-Cell, Diffuse
/ complications
Macula Lutea
/ drug effects
Male
Middle Aged
Retinal Diseases
/ chemically induced
Retrospective Studies
Tomography, Optical Coherence
/ methods
United States
/ epidemiology
Journal
Ophthalmic surgery, lasers & imaging retina
ISSN: 2325-8179
Titre abrégé: Ophthalmic Surg Lasers Imaging Retina
Pays: United States
ID NLM: 101599215
Informations de publication
Date de publication:
01 05 2020
01 05 2020
Historique:
received:
28
01
2020
accepted:
10
02
2020
entrez:
3
6
2020
pubmed:
3
6
2020
medline:
15
4
2021
Statut:
ppublish
Résumé
To describe the incidence, characteristics, and risk factors of a pigmentary maculopathy in patients with primary central nervous system (CNS) lymphoma treated with blood-brain barrier disruption (BBBD) therapy. This retrospective chart review included patients with biopsy-proven primary CNS lymphoma treated with or without BBBD therapy who underwent an ophthalmic examination after starting systemic treatment. Clinical data and all available retinal imaging were analyzed. Fifty-eight patients met inclusion criteria. Twenty-one of 36 patients treated with BBBD therapy had a bilateral pigmentary maculopathy. None of the 22 patients treated with conventional chemotherapy had similar changes. Additional findings in patients treated with BBBD included geographic retinal pigment epithelium atrophy, subretinal fluid, and in one case, choroidal neovascularization. Some cases of maculopathy resulted in reduced visual acuity. The presence of a pigmentary maculopathy was associated with a higher number of BBBD treatment sessions (20.1 vs 13.3, P = .016), but not vitreoretinal lymphoma involvement or intravitreal methotrexate injections. In this cohort, 58.3% of patients with primary CNS lymphoma treated with BBBD and chemotherapy were found to have a bilateral pigmentary maculopathy. This maculopathy can result in reduced visual acuity and is associated with the number of BBBD treatment sessions. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S5-S12.].
Sections du résumé
BACKGROUND AND OBJECTIVE
To describe the incidence, characteristics, and risk factors of a pigmentary maculopathy in patients with primary central nervous system (CNS) lymphoma treated with blood-brain barrier disruption (BBBD) therapy.
PATIENTS AND METHODS
This retrospective chart review included patients with biopsy-proven primary CNS lymphoma treated with or without BBBD therapy who underwent an ophthalmic examination after starting systemic treatment. Clinical data and all available retinal imaging were analyzed.
RESULTS
Fifty-eight patients met inclusion criteria. Twenty-one of 36 patients treated with BBBD therapy had a bilateral pigmentary maculopathy. None of the 22 patients treated with conventional chemotherapy had similar changes. Additional findings in patients treated with BBBD included geographic retinal pigment epithelium atrophy, subretinal fluid, and in one case, choroidal neovascularization. Some cases of maculopathy resulted in reduced visual acuity. The presence of a pigmentary maculopathy was associated with a higher number of BBBD treatment sessions (20.1 vs 13.3, P = .016), but not vitreoretinal lymphoma involvement or intravitreal methotrexate injections.
CONCLUSION
In this cohort, 58.3% of patients with primary CNS lymphoma treated with BBBD and chemotherapy were found to have a bilateral pigmentary maculopathy. This maculopathy can result in reduced visual acuity and is associated with the number of BBBD treatment sessions. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S5-S12.].
Identifiants
pubmed: 32484895
doi: 10.3928/23258160-20200108-01
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S5-S12Informations de copyright
Copyright 2020, SLACK Incorporated.