Lindsey D. Harris, MD (Atlanta, GA), Daniel F. Martin, MD (Atlanta, GA), Thomas M. Aaberg, MD (Atlanta, GA), G. Baker Hubbard, MD (Atlanta, GA), Ian Crocker, MD (Atlanta, GA)

PURPOSE:

To report long term results of seven eyes of six patients with uveal lymphoid infiltration refractory to medical therapy that were treated with radiation at the Emory Eye Center from 1995 to 2005.

METHODS:

A retrospective case series of seven eyes of six consecutive patients referred to the Emory Eye Center from 1995 to 2005 with uveal lymphoid infiltration that were treated with radiation after medical therapy failed. Main outcome measures were visual acuity and inactivity of the disease. Inactivity was defined as exudative retinal detachment resolution.

RESULTS:

Seven of six patients were diagnosed with uveal lymphoid infiltration. All patients had diffuse choroidal thickening, exudative retinal detachments and peripapillary nodules evident on ultrasonography. One patient had orbital involvement. All patients failed steroid treatment. One patient failed treatment with methotrexate. Subsequently all patients received radiation in divided doses. Five eyes received 20 gray with 2 gray per fraction. Two eyes received 27 gray with 1.8 gray per fraction. Pretreatment  visual acuity was HM, HM, NLP, 20/400, 20/30, 20/40 and 20/400. Posttreatment visual acuity was HM, 20/80, NLP, 20/400, 20/20, 20/30 and 20/20, respectively. The patient with orbital involvement and NLP visual acuity died within one month of radiotherapy secondary to complications of metastatic renal cell carcinoma. The remaining six eyes achieved resolution of exudative detachments. Follow-up after radiation treatment was 27.6 months (range one month to 101 months).

CONCLUSION:

Radiation for uveal lymphoid infiltration refractory to medical treatment was an effective treatment in this case series for long term maintenance of visual acuity and disease inactivity. Four eyes had improved visual acuity; two eyes had no change in visual acuity. One patient died of complications of metastatic renal cell carcinoma. Inactivity was achieved in the remaining six eyes.