A group of investigators from seven different centers around the world came together to investigate and characterize the clinical features of subtype-specific orbital lymphoma.
The retrospective, interventional case series collected patient data from January 1, 1980 through December 31, 2017, comprising 797 patients with a histologically verified orbital lymphoma. The primary endpoints were overall survival, disease-specific survival and progression-free survival. The median age was 64 years, and 51 percent of patients (n=407) were male.
The researchers report that most of the lymphomas were of B-cell origin (98 percent, n=779). Extranodal marginal zone B-cell lymphoma (EMZL) was the most frequent subtype (57 percent, n=452), followed by diffuse large B-cell lymphoma (DLBCL) (15 percent, n=118), follicular lymphoma (FL) (11 percent, n=91), and mantle cell lymphoma (MCL) (8 percent, n=66). Localized, Ann Arbor stage IE EMZL and FL were frequently treated with external beam radiation therapy. DLBCL, MCL and disseminated EMZL and FL were primarily treated with chemotherapy. EMZL and FL patients had a markedly better prognosis (10-year disease-specific survival of 92 percent and 71 percent, respectively) than DLBCL and MCL patients (10-year disease-specific survival of 41 percent and 32 percent, respectively).
Am J Ophthalmol 2019;199:44-57.
Olsen TG, Holm F, Mikkelson LH, Rasmussen PK, Coopland SE, et al.
Identifying Babies at Low Risk For Developing ROP
Most premature infants don’t end up developing retinopathy of prematurity. However, due to difficulties in determining those at risk, sensitive screening procedures for premature infants persist after NICU discharge—even in infants without ROP. In a recent study, which took place in North American neonatal intensive-care units, doctors sought to understand the factors associated with premature infants being at low risk, and to identify those who wouldn’t benefit from continued ROP monitoring post hospital discharge.
Currently, screening for ROP begins at 32 weeks postmenstrual age and continues every one to two weeks until the retinal vessels have matured, which is around 40 weeks. Only 5 percent of at-risk infants are eventually treated, however. The evaluations are seen as uncomfortable for the infant and can pose a burden to ophthalmologists, since physicians with ROP experience are limited.
In the study, 1,257 infants with birth weights less than 1,251 g, who were born at 22 to 35 weeks’ gestation, were monitored during all in-hospital examinations to determine birth characteristics associated with the absence of ROP, and identify those who would be considered low risk for subsequent ROP treatment. The infants underwent 4,113 ROP examinations between 31 and 47 weeks’ postmenstrual age; 1,153 exams found no ROP, and 456 infants showed no ROP prior to study center discharge. There was no ROP in 59 percent of infants of 27 to 33 weeks gestation age compared to 15 percent of infants younger than 27 weeks at the time of hospital discharge. Larger birth weight and higher gestational age were significantly associated with absence of ROP in a multivariate analysis of infants born between 27 and 33 weeks gestation.
The study concluded by identifying characteristics that are associated with low likelihood of developing ROP. These factors include infants at 27 weeks’ gestational age or greater who have a birth weight of at least 750 g. The researchers add that if ROP hasn’t been detected by the time the infant is discharged, continued surveillance would have limited value.
JAMA Ophthalmology 2019;137:160-166
Wade K, Ying G, Baumritter A, et al.