[Relapsed primary intraocular lymphoma treated with intravitreal methotrexate and high-dose chemotherapy followed by autologous stem cell rescue].

A 58-year-old woman with primary intraocular lymphoma (PIOL) of her right eye was treated with combination chemotherapy (methotrexate, procarbazine and vincristine) followed by irradiation to her brain and right eye. However, the disease recurred in the right eye four months later. She was treated with intravitreal injection of methotrexate and high-dose chemotherapy in combination with autologous stem cell transplantation after salvage therapy consisting of cytarabine, etoposide and rituximab. With this treatment strategy, she has been in remission for more than one year with no deterioration of either leukoencephalopathy or cognitive function. Intravitreal injection of methotrexate and high-dose chemotherapy may now be regarded as one of the treatment choices for relapsed PIOL.

Different Filling Patterns of the Choriocapillaris in Fluorescein and Indocyanine Green Angiography in Primate Eyes Under Elevated Intraocular Pressure.

Purpose: To investigate the hemodynamics of the choriocapillaris in primate eyes under elevated intraocular pressure. Methods: Indocyanine green angiography (ICGA) and fluorescein angiography (FA) were performed in two monkeys after elevation of the intraocular pressure (IOP) to 35 and 60 mm Hg. Results: ICGA and FA showed no perfusion delays in the choriocapillaris at 35 mm Hg. The slow dye filling at 60 mm Hg made it possible to observe the early phase angiography sequence. During ICGA, C-shaped precapillary arterioles multiplied in numbers and emerged in the posterior pole, forming the outer rim of the numerous mosaics or lobules. Dye subsequently infiltrated into the lobules. During FA, after numerous hyperfluorescent spots emerged in the posterior pole, each of the spots enlarged and became numerous mosaics with a dark outer rim. When the FA and ICGA images were superimposed, the C-shaped arterioles observed during the ICGA were shown to correspond to the outer dark rim of the mosaics seen during the FA. The earliest dye emergence was delayed during FA compared to ICGA, with 13 seconds elapsing in monkey 1 and 4 seconds in monkey 2. The horizontal diameter of the optic disc contained three to four mosaics in both monkeys. Conclusions: The choriocapillaris lobules appear to be supplied from peripheral arterioles, not central. After blood perfuses the lobules, it drains into the venules at the center. Mosaic or lobular patterns during FA may reflect extravasated fluorescein from the fenestrated choriocapillaris.