| Presentation preference | Poster presentation |
| Title | Treatment of Vitreoretinal Lymphoma – Ocular and Systemic Outcomes |
| Purpose | Vitreoretinal lymphoma is an intraocular malignant lymphocytic neoplasm affecting the retina and/or vitreous. Although rare, it is an important diagnosis that should not be missed as majority of patients have concurrent or subsequent CNS involvement with significant morbidity and mortality. Diagnosis can be challenging and treatment options vary significantly between institutions – they include intravitreal methotrexate (IVT MTX) or rituximab, systemic chemotherapy, radiotherapy, and/or a combination of different modalities. While there is no international consensus for treatment, one of the most common regimens for IVT MTX involves an induction phase of twice-weekly injections (400μg MTX in 0.1ml) for 1 month, followed by weekly consolidation injections for 1-2 months and subsequent a maintenance phase of monthly injections for 1 year. However, based on our experience, the twice-weekly frequency of induction injections is poorly tolerated by patients who often experience significant corneal epitheliopathy. As such, we have modified our treatment practice, in particular, to reduce the frequency of IVT MTX at the induction phase. |
| Methods | This is a retrospective review of 5 VRL cases managed at the Singapore National Eye Centre. |
| Results | We have found that our patients experienced good ocular response to weekly induction IVT MTX and were able to tolerate the injections better. 4 out of 5 patients also achieved systemic and ocular remission following combination therapy (IVT MTX with systemic chemotherapy). |
| Conclusion | We advocate the use of combination therapy and in our experience, weekly induction IVT MTX injections have been sufficient to achieve ocular response, with significant improvements to patient tolerability to therapy. |
| Conflict of interest | No |
Authors 1
| Last name | LOO |
| Initials of first name(s) | Y |
| Department | Singapore National Eye Centre |
| City | Singapore |
| Country | Singapore |
Authors 2
| Last name | Chang |
| Initials of first name(s) | EWY |
| Department | National Cancer Centre Singapore |
| City | Singapore |
| Country | Singapore |
Authors 3
| Last name | Poon |
| Initials of first name(s) | E |
| Department | National Cancer Centre Singapore |
| City | Singapore |
| Country | Singapore |
Authors 4
| Last name | Tan |
| Initials of first name(s) | YH |
| Department | National Cancer Centre Singapore |
| City | Singapore |
| Country | Singapore |
Authors 5
| Last name | Chan |
| Initials of first name(s) | ASY |
| Department | Singapore National Eye Centre |
| City | Singapore |
| Country | Singapore |
