Maculopathy as a complication of blood-brain barrier disruption in patients with central nervous system lymphoma

Anat Galor; Sandra J Ference; Arun D Singh; Michael S Lee; Glen H J Stevens; Victor L Perez; David M Peereboom

doi:10.1016/j.ajo.2007.03.057

Maculopathy as a complication of blood-brain barrier disruption in patients with central nervous system lymphoma

Am J Ophthalmol. 2007 Jul;144(1):45-49. doi: 10.1016/j.ajo.2007.03.057.

Authors

Anat Galor¹, Sandra J Ference, Arun D Singh, Michael S Lee, Glen H J Stevens, Victor L Perez, David M Peereboom

Affiliation

¹ Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

PMID: 17601426
DOI: 10.1016/j.ajo.2007.03.057

Abstract

Purpose: To report on the development of visually significant maculopathy associated with blood-brain barrier disruption (BBBD) therapy for the treatment of central nervous system (CNS) lymphoma.

Design: Retrospective case series.

Methods: Chart review of 20 patients undergoing BBBD therapy for treatment of CNS lymphoma at the Cleveland Clinic. Patients with documented maculopathy were included in analysis.

Results: Seven (54%) of 13 patients were identified with new macular retinal pigment epithelium (RPE) changes after BBBD treatment. The RPE changes consisted of fine clumps of hyperpigmentation in the foveal region associated with variable degrees of RPE loss. These changes were bilateral but often asymmetric. Two patients had decreased visual acuity resulting from maculopathy. One patient had documented progression of maculopathy after completion of treatment.

Conclusions: Maculopathy is a frequent finding after BBBD therapy for CNS lymphoma.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Antimetabolites, Antineoplastic / administration & dosage
Antimetabolites, Antineoplastic / adverse effects*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Blood-Brain Barrier / drug effects*
Brain Neoplasms / drug therapy*
Carotid Artery, Internal
Catheterization, Peripheral
Cyclophosphamide / administration & dosage
Cytarabine / administration & dosage
Etoposide / administration & dosage
Female
Fluorescein Angiography
Humans
Injections, Spinal
Lymphoma / drug therapy*
Male
Mannitol / administration & dosage
Mannitol / adverse effects*
Methotrexate / administration & dosage
Methotrexate / adverse effects*
Middle Aged
Pigment Epithelium of Eye / drug effects
Pigment Epithelium of Eye / pathology
Retinal Diseases / chemically induced*
Retinal Diseases / diagnosis
Retrospective Studies
Tomography, Optical Coherence
Vertebral Artery

Substances

Antimetabolites, Antineoplastic
Cytarabine
Mannitol
Etoposide
Cyclophosphamide
Methotrexate