Prognosis, Risk Factors, and Clinical Features of Intraocular Recurrence in Primary Vitreoretinal Lymphoma

To investigate the clinical features, risk factors, and prognosis of the intraocular recurrence in primary vitreoretinal lymphoma (PVRL). Retrospective case-control study. 97 eyes of 51 patients diagnosed with PVRL between 2011/12 and 2021/1 were enrolled in this study. 14 patients among them had experienced intraocular recurrence. Date on demographic and ophthalmic characteristics, results of diagnostic tests, treatments, prognosis of intraocular recurrence and non-recurrence PVRL patients were collected and compared. Multivariate logistic regression was used to identify independent risk factors. And receiver operating characteristic curve was conducted to determine the cut-off values. Clinical features and risk factors. 14 (19 eyes) of 51 PVRL patients had intraocular recurrences, resulting in a recurrence rate of 27.5% over a mean follow-up period of 42.5 months. No difference was observed in central nervous system lymphoma (CNSL) relapse rate (54.3% vs. 64.3%, p=0.523) and median time to CNSL (36.5 95%CI [24.6-48.3] vs. 37.3 95%CI [24.8-49.8], p=0.777) between intraocular non-recurrence and intraocular recurrence groups. Furthermore, there were no statistically significant difference in the survival outcomes, such as mortality (28.6% vs. 29.7%, p=1.000) and median overall survival (70.8 95%CI [54.0-87.7] vs. 59.2 95%CI [44.8-73.6], p=0.297), between these two groups. Younger onset age (odds ratio [OR] 0.90, 95% confidence intervals [CI] 0.84-0.98, p=0.010), isolated PVRL (OR 35.3, 95%CI 2.08-600.0, p=0.014), and no history of intravitreal chemotherapy (OR 7.72, 95%CI 1.37-43.6, p=0.021) were identified as independent risk factors for intraocular recurrences. Of the patients with intraocular recurrence, 23.6% were asymptomatic and were diagnosed during routine follow-up. The rate of interleukin-10 (IL-10) /IL-6>1 was significantly lower than that at diagnosis (43.8% vs. 92.3%, p=0.008). However, the rate of IL-10≥50 pg/mL was high (81.3%) and not significantly different from that at diagnosis (92.3%, p=0.606). This study did not identify an impact of intraocular recurrence on CNS manifestations or survival outcomes in patients with PVRL. Younger patients have a higher risk of intraocular recurrence, and combined systemic and intravitreal chemotherapy may reduce intraocular recurrence. Regular ophthalmic follow-up and IL-10 testing are recommended to detect intraocular recurrence.