Ocular Lymphoma

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Very rarely, lymphoma begins inside the eyes. Intraocular lymphomas are typically a type of non-Hodgkin lymphoma. Often, they are associated with central nervous system lymphoma and may appear as a mild, chronic inflammation inside the eye.

Eye lymphomas may spread to the brain and often spread before a diagnosis. Our comprehensive diagnostic process gives you a full and accurate determination of your health.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Ocular chemotherapy experts. The Sylvester-Bascom Palmer partnership allows precision chemotherapy treatment. Our expertise with injecting chemotherapy directly into the eye to treat cancer makes your treatment more effective and creates far fewer side effects.

More experience treating ocular lymphoma. You receive care from a team of the nation’s leading cancer and eye care providers, with no unnecessary delays caused by misdiagnosis.

Coordinated diagnosis. Because our surgeons and cellular experts (pathologists) work together, you receive an accurate interpretation of biopsies or test results the first time. This means improved accuracy and better treatment outcomes.

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Treatments

Each case is reviewed by our multidisciplinary team of eye cancer experts. Your team of specialists checks your test results to create a personalized treatment plan. Your plan may include a combination of the following treatment options:

External Beam Radiation Therapy

Intensity modulated radiation therapy (IMRT) delivers advanced external beam radiation therapy that allows our radiation specialists to tailor radiation doses to the exact three-dimensional shape of a tumor. This technology is ideal for irregularly shaped tumors like intraocular tumors.
- IMRT minimizes the amount of radiation affecting the surrounding healthy tissue. It is often used for intraocular lymphoma, orbital lymphoma, and lymphomas of the tear glands and eyelids.
- Treatment is usually given only to both eyes to help prevent lymphoma from spreading or to destroy cancer cells already be there.
Chemotherapy

Chemotherapy drugs are given through a vein, directly into the cerebrospinal fluid or directly into the eye. The choice depends on the severity of the cancer. If administered into the eye, this targets higher doses of the drug to the tumor. Radiation therapy may be used at the same time for a stronger effect.
Immunotherapy / Biologic Therapy

Also called biologic therapy, immunotherapy boosts the body's natural defenses to fight the tumor. One type, monoclonal antibodies, may be given directly into the eye. The best combination and dosage of drugs depends on what type of lymphoma you have. Rituximab is the most common immunotherapy used for treating non-Hodgkin lymphoma.

Tests

During an eye exam, your doctor will ask about your symptoms and may check your vision and eye movements with an indirect ophthalmoscope (an instrument with a light and a small magnifying lens). If lymphoma is present, the vitreous (the jelly-like substance that fills most of the inside of the eye) may be cloudy.

Imaging tests used for diagnosing intraocular lymphoma can include:

Ultrasound

This test is usually done to determine the size, shape, and location of the tumor. Sylvester has state-of-the-art ultrasound machines with dedicated highly trained ultrasound technicians. Working with Bascom Palmer eye experts, they produce fast, accurate diagnostic results.

Magnetic Resonance Imaging (MRI) Scan

An MRI of the head allows us to see inside the eye and to look for lymphoma in the brain or meninges (thin tissues covering the brain and spinal cord). If cancer is seen in the meninges, it can indicate a central nervous system lymphoma.

Positron Emission Tomography (PET) Scan

PET scans help us determine if the lymphoma has spread to the lymph nodes or to other parts of the body.

Computerized Tomography (CT) Scan

X-rays take a series of pictures of the inside of your eye and surrounding structures. These images are then combined by a computer, giving clear 3-D images of the area.

Biopsy

Symptoms and tests might suggest you have intraocular lymphoma, but a biopsy is usually needed to confirm the diagnosis. An ophthalmologist often will perform a vitrectomy for a biopsy. Under local or general anesthesia, the doctor takes a sample of the vitreous gel from inside the eye. The cells in the biopsy sample are sent to a lab to be examined under a microscope and tested for signs of lymphoma.

Non-Hodgkin lymphoma is the most common primary orbital cancer and of the adjacent parts of the eye. The most frequently altered gene responsible for this condition is called MYD88. Studying this gene can tell us how aggressive your tumor might be and its most effective treatments.

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