Therapeutic Effects of Intravitreal Methotrexate Injection for Intraocular Lymphoma Diagnosed Using Immunocytochemical Staining
10.3341/jkos.2025.66.2.101
- Author:
Yong Jin NA
1
;
Kun Young KWON
;
Kook Young KIM
;
Young Suk CHANG
;
Jung Tae KIM
Author Information
1. Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
- Publication Type:Original Article
- From:Journal of the Korean Ophthalmological Society
2025;66(2):101-113
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:This study evaluated the therapeutic efficacy of intravitreal methotrexate (MTX) injections in patients diagnosed with intraocular lymphoma via vitrectomy and immunocytochemical staining.
Methods:In a retrospective analysis of medical records, we reviewed data from four patients (six eyes) diagnosed with intraocular lymphoma cytologically after undergoing vitrectomy at our hospital between December 2021 and December 2023. Each case was followed for a minimum of 6 months after treatment, with comparisons made between pre- and post-treatment observations
Results:The mean age of the patients was 63.5 ± 9.8 years, with an average interval of 29.3 ± 32.0 months from initial symptom onset to intraocular lymphoma diagnosis. Diagnosis was confirmed through cytological and immunocytochemical analysis of vitreous specimens, identifying diffuse large B-cell lymphoma in four eyes and atypical lymphoid cells in two eyes. On average, 14.0 ± 1.7 intravitreal MTX injections were administered per eye. The mean best-corrected visual acuity improved from 1.18 ± 0.90 pre-treatment to 0.37 ± 0.70 post-treatment. Ophthalmic complications included toxic keratopathy in three eyes and retinal hemorrhage in one eye. Additionally, nasal cavity lymphoma was diagnosed in two patients.
Conclusions:Diagnostic vitrectomy combined with cytology and immunocytochemical staining is essential for the early diagnosis of intraocular lymphoma and differentiation from inflammatory diseases, such as uveitis. Intravitreal MTX injections can induce clinical remission in intraocular lymphoma cases.
