PRIMARY LYMPHOMA OF THE EYE

Lymphomas in the eye tend to be localized and to have a better prognos is. We reviewed the clinical presentation, treatment outcome and compl ications of primary lymphomas of the eye at a single institute focusin g on the clinical significance of adequate staging and the prognostic value of pathological subtypes. Twenty-four patients with lymphoprolif erative lesions of the eye were treated and followed up. The orbit was the most commonly involved site. Twenty-one patients had unilateral d iseases and three patients had bilateral. Histological findings reveal ed 22 malignant lymphomas, one inflammatory pseudotumor and one atypic al lymphoid hyperplasia. Using the NCI Working Formulation, most of th e malignant lymphomas were primarily low grade: diffuse small lymphocy tic, 15; diffuse small cleaved three; diffuse large cell, three; and d iffuse mixed, one. The stages of lymphoma were IAE in 21 patients, IBE in one patient, and IIAE in two patients. Twenty;five of the 27 treat ed eyes remained disease-free during the median follow-up period of 16 months. Nineteen patients received radiotherapy, five patients receiv ed chemo-radiotherapy and one patient received only surgical excision. Two patients relapsed outside the treated field. None of the patients complained of severe dry eye syndrome or cataract formation. In concl usion, after complete staging work-up, locally-confined low grade orbi tal lymphomas can be up to 90% controlled with radiotherapy alone, By contrast, combined treatment is advised in patients with intermediate and high grade lesions.