Prognosis, Risk Factors and Clinical Features of Intraocular Recurrence in Primary Vitreoretinal Lymphoma.

PURPOSE: To investigate the clinical features, risk factors, and prognosis of the intraocular recurrence in primary vitreoretinal lymphoma (PVRL).

DESIGN: Retrospective case-control study.

PARTICIPANTS: 97 eyes of 51 patients diagnosed with PVRL between 2011/12 and 2021/1 were enrolled in this study. 14 patients among them had experienced intraocular recurrence.

METHODS: Date on demographic and ophthalmic characteristics, results of diagnostic tests, treatments, prognosis of intraocular recurrence and non-recurrence PVRL patients were collected and compared. Multivariate logistic regression was used to identify independent risk factors. And receiver operating characteristic curve was conducted to determine the cut-off values.

MAIN OUTCOME MEASURES: Clinical features and risk factors.

RESULTS: 14 (19 eyes) of 51 PVRL patients had intraocular recurrences, resulting in a recurrence rate of 27.5% over a mean follow-up period of 42.5 months. No difference was observed in central nervous system lymphoma (CNSL) relapse rate (54.3% vs. 64.3%, p=0.523) and median time to CNSL (36.5 95%CI [24.6-48.3] vs. 37.3 95%CI [24.8-49.8], p=0.777) between intraocular non-recurrence and intraocular recurrence groups. Furthermore, there were no statistically significant difference in the survival outcomes, such as mortality (28.6% vs. 29.7%, p=1.000) and median overall survival (70.8 95%CI [54.0-87.7] vs. 59.2 95%CI [44.8-73.6], p=0.297), between these two groups. Younger onset age (odds ratio [OR] 0.90, 95% confidence intervals [CI] 0.84-0.98, p=0.010), isolated PVRL (OR 35.3, 95%CI 2.08-600.0, p=0.014), and no history of intravitreal chemotherapy (OR 7.72, 95%CI 1.37-43.6, p=0.021) were identified as independent risk factors for intraocular recurrences. Of the patients with intraocular recurrence, 23.6% were asymptomatic and were diagnosed during routine follow-up. The rate of interleukin-10 (IL-10) /IL-6>1 was significantly lower than that at diagnosis (43.8% vs. 92.3%, p=0.008). However, the rate of IL-10≥50 pg/mL was high (81.3%) and not significantly different from that at diagnosis (92.3%, p=0.606).

CONCLUSIONS: This study did not identify an impact of intraocular recurrence on CNS manifestations or survival outcomes in patients with PVRL. Younger patients have a higher risk of intraocular recurrence, and combined systemic and intravitreal chemotherapy may reduce intraocular recurrence. Regular ophthalmic follow-up and IL-10 testing are recommended to detect intraocular recurrence.