原发性玻璃体视网膜淋巴瘤眼内化学药物治疗

Intravitreal chemotherapy in the treatment of primary vitreoretinal lymphoma

原发性玻璃体视网膜淋巴瘤（PVRL）是非霍奇金淋巴瘤的罕见类型,预后差,治疗尚无统一方案.既往或正在使用的治疗方法包括眼球摘除、眼部放射治疗（放疗）、全身化学药物治疗（化疗）、眼内化疗等.其中,眼部放疗能有效清除肿瘤细胞但复发率高;全身化疗为目前主流的治疗选择,但仍存在眼内病灶不能完全缓解或复发率高问题;眼内化疗作为全身化疗的辅助治疗,可提高缓解率,眼内复发率较眼部放疗低,严重并发症少,在清除肿瘤细胞同时可保留患者视功能.眼内化疗药物选择、给药方案,对于初发PVRL是否可只行眼内化疗以及眼内化疗的作用是改善视力抑或是提高患者生存率仍值得进一步研究.

Primary vitreoretinal lymphoma （PVRL） is a rare type of non-Hodgkin＇s lymphoma with poor prognosis and the optimal treatment has yet to be determined.Its treatment has evolved from enucleation to ocular radiotherapy,systemic chemotherapy and intravitreal chemotherapy.Radiotherapy can effectively eradicate tumor cells but ocular recurrences are common.Systemic chemotherapy has become the mainstream option but there are problems with only-partial response of PVRL and high rate of recurrence.Intravitreal chemotherapy,primarily used as adjunctive to systemic chemotherapy,has achieved high remission rate and low rate of recurrence as well as with limited ocular complications.The tumor cells were cleared and the visual function preserved.However,issues about the drug applied,treatment protocols and goals of intravitreal chemotherapy,whether for visual preservation or survival improvement,are worthy for further study.