Korean J Ophthalmol.  2013 Aug;27(4):243-248. 10.3341/kjo.2013.27.4.243.

Risk Potentiality of Frontline Radiotherapy Associated Cataract in Primary Ocular Adnexal Mucosa-associated Lymphoid Tissue Lymphoma

• Cho WK
• Lee SE
• Paik JS
• Cho SG
• Yang SW

• KMID: 1705419
• DOI: http://doi.org/10.3341/kjo.2013.27.4.243

Abstract

PURPOSE
To elucidate risk potentiality of frontline radiotherapy associated cataracts in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML).
METHODS
Data from eight consecutive patients of 41 total OAML patients who had undergone cataract surgery after frontline radiotherapy were analyzed.
RESULTS
The median patient age was 46 years (range, 36 to 69 years). The median total radiation dose was 3,780 cGy (range, 3,060 to 4,500 cGy), and the mean duration from radiation irradiation to cataract surgery was 36.60 +/- 8.93 months. Preoperative lens opacification was primarily at the posterior lens subcapsule, and best-corrected visual acuity (BCVA) was 0.43 +/- 0.21. Patients underwent the phacoemulsification surgical procedure with posterior chamber intraocular lens insertion. The average BCVA improved to 0.90 +/- 0.14 after cataract surgery. Two patients underwent posterior continuous curvilinear capsulorhexis, and one had posterior capsule rupture. For posterior capsule opacification (PCO), three patients received Nd:YAG laser posterior capsulotomy after the initial surgery, and one patient is currently under consideration for laser posterior capsulotomy.
CONCLUSIONS
Radiotherapy increased posterior subcapsule opacification at a relatively young age in primary OAML. Phacoemulsification was a manageable procedure without severe complications, and final visual outcomes were good. However, because after-cataracts progressed earlier than did senile cataracts, close follow-up should be considered for PCO management.

Keyword

Cataract; Ocular adnexal mucosa-associated lymphoid tissue lymphoma; Radiotherapy

MeSH Terms

Adult
Aged
Cataract/*epidemiology/etiology
Eye Neoplasms/*radiotherapy
Female
Follow-Up Studies
Humans
Lymphoma, B-Cell, Marginal Zone/*radiotherapy
Male
Middle Aged
*Phacoemulsification
Radiation Dosage
Radiotherapy/*adverse effects
Retrospective Studies
Risk Factors

Reference

1. Nam H, Ahn YC, Kim YD, et al. Prognostic significance of anatomic subsites: results of radiation therapy for 66 patients with localized orbital marginal zone B cell lymphoma. Radiother Oncol. 2009; 90:236–241. PMID: 18950885.

2. Yadav BS, Sharma SC. Orbital lymphoma: role of radiation. Indian J Ophthalmol. 2009; 57:91–97. PMID: 19237780.

3. Yoon JS, Ma KT, Kim SJ, et al. Prognosis for patients in a Korean population with ocular adnexal lymphoproliferative lesions. Ophthal Plast Reconstr Surg. 2007; 23:94–99.

4. Ferreri AJ, Dolcetti R, Du MQ, et al. Ocular adnexal MALT lymphoma: an intriguing model for antigen-driven lymphomagenesis and microbial-targeted therapy. Ann Oncol. 2008; 19:835–846. PMID: 17986622.

5. Stefanovic A, Lossos IS. Extranodal marginal zone lymphoma of the ocular adnexa. Blood. 2009; 114:501–510. PMID: 19372259.

6. De Cicco L, Cella L, Liuzzi R, et al. Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis. Radiat Oncol. 2009; 4:60. PMID: 19968864.

7. Ferrufino-Ponce ZK, Henderson BA. Radiotherapy and cataract formation. Semin Ophthalmol. 2006; 21:171–180. PMID: 16912015.

8. Decaudin D, Dendale R, Lumbroso-Le Rouic L. Treatment of mucosa-associated lymphoid tissue-type ocular adnexal lymphoma. Anticancer Drugs. 2008; 19:673–680. PMID: 18594208.

9. Ainsbury EA, Bouffler SD, Dorr W, et al. Radiation cataractogenesis: a review of recent studies. Radiat Res. 2009; 172:1–9. PMID: 19580502.

10. Son SH, Choi BO, Kim GW, et al. Primary radiation therapy in patients with localized orbital marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT Lymphoma). Int J Radiat Oncol Biol Phys. 2010; 77:86–91. PMID: 19632068.

11. Osman IM, Abouzeid H, Balmer A, et al. Modern cataract surgery for radiation-induced cataracts in retinoblastoma. Br J Ophthalmol. 2011; 95:227–230. PMID: 20576779.

12. Bischof M, Karagiozidis M, Krempien R, et al. Radiotherapy for orbital lymphoma: outcome and late effects. Strahlenther Onkol. 2007; 183:17–22. PMID: 17225941.

13. Shore RE, Neriishi K, Nakashima E. Epidemiological studies of cataract risk at low to moderate radiation doses: (not) seeing is believing. Radiat Res. 2010; 174:889–894. PMID: 21128813.

14. Coupland SE, White VA, Rootman J, et al. A TNM-based clinical staging system of ocular adnexal lymphomas. Arch Pathol Lab Med. 2009; 133:1262–1267. PMID: 19653722.

15. Lee SE, Paik JS, Cho WK, et al. Feasibility of the TNM-based staging system of ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Am J Hematol. 2011; 86:262–266. PMID: 21328439.

16. Behrens R, Dietze G. Monitoring the eye lens: which dose quantity is adequate? Phys Med Biol. 2010; 55:4047–4062. PMID: 20601777.

17. Monzen Y, Hasebe H. Radiotherapy for localized orbital mucosa-associated lymphoid tissue lymphoma. Ophthalmologica. 2007; 221:233–237. PMID: 17579288.

18. Wachtlin J, Bechrakis NE, Schueler AO, et al. Phacoemulsification following treatment of choroidal melanoma. Graefes Arch Clin Exp Ophthalmol. 2000; 238:942–948. PMID: 11196355.

19. Schaumberg DA, Dana MR, Christen WG, Glynn RJ. A systematic overview of the incidence of posterior capsule opacification. Ophthalmology. 1998; 105:1213–1221. PMID: 9663224.

20. Kucuksumer Y, Bayraktar S, Sahin S, Yilmaz OF. Posterior capsule opacification 3 years after implantation of an AcrySof and a MemoryLens in fellow eyes. J Cataract Refract Surg. 2000; 26:1176–1182. PMID: 11008045.

21. Montenegro GA, Marvan P, Dexl A, et al. Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy. Am J Ophthalmol. 2010; 150:248–253. PMID: 20541740.

22. Kao SC, Kau HC, Tsai CC, et al. Lacrimal gland extranodal marginal zone B-cell lymphoma of MALT-type. Am J Ophthalmol. 2007; 143:311–316. PMID: 17184716.