Clinical Characteristics and Outcomes of Vitreoretinal Lymphoma: A 10-Year Single-Center Retrospective Review

Document Type

Conference Proceeding

Publication Date

6-2026

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : Vitreoretinal lymphoma (VRL) is a rare intraocular manifestation of either primary central nervous system lymphoma or secondary metastasis. Diagnosis is challenging due to overlap with uveitis and limited diagnostic yield from vitreous samples. Treatment lacks standardization, with approaches ranging from intravitreal therapy to systemic chemotherapy. We report a 10-year single-center experience evaluating diagnostic findings, management strategies, and outcomes in VRL.

Methods : A single center retrospective review was conducted of all patients diagnosed with intraocular lymphoma (ICD-10 code C79.32) from 2015-2024. Demographics, clinical presentations, systemic evaluation, diagnosis and treatment algorithms were analyzed. The primary endpoint was the response rate (RR); secondary endpoints included progression free survival (PFS) and overall survival (OS).

Results : Fourteen patients (25 eyes) met inclusion criteria. Mean age at diagnosis was 73.3 years (range 56-86), with mean follow up of 34 months. Mean time from symptom onset to initial presentation was 8.7 months (std 7.2), and from presentation to diagnosis was 4 months (std 3.6) The most common presentation (88%) was intermediate and posterior uveitis with vitritis and outer changes. Eight patients (57.1%) had primary VRL and six (42.9%) had secondary VRL. All underwent systemic workup with CT-PET, neuroimaging and lumbar puncture; 13 of 14 patients had diagnostic vitrectomy and one had brain biopsy. Cytology was positive in 78.6%, flow cytometry in 50%, and MYD88 L265P mutation in 64.3%. Treatment included systemic chemotherapy in 71.4% (10 patients), with 2 receiving adjuvant intravitreal methotrexate (IV-MTX) and 2 radiotherapy; 2 received IV-MTX alone, 1 radiotherapy alone, and 1 both IV-MTX and radiotherapy. The overall RR was 92.3% (24 eyes). PFS was 92.3% at 1 year and 38% at 5 years; OS was 100% at 1 year and 50% at 5 years.

Conclusions : This 10-year single-center review demonstrates high initial response rates in VRL treated with systemic and adjuvant therapy, yet long-term PFS and OS remain below 50% at 5 years. Despite diagnostic delays averaging 4 months, most patients achieved initial remission, underscoring both the aggressiveness of VRL and the need for earlier recognition and standardized treatment strategies.

Volume

67

Issue

7

First Page

187

Comments

Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting, May 3-7, 2026, Denver, CO

Last Page

187

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