Hildegaard Priem

Ocular non-Hodgkin’s lymphoma: a clinical study of nine cases

BACKGROUND Primary oculocerebral large cell malignant non-Hodgkin’s lymphoma, formerly called ocular reticulum cell sarcoma, runs a uniformly fatal course. Once the central nervous system (CNS) is involved, survival without treatment is very limited. Although treatment does not substantially improve the long term survival, it provides short term improvement in these patients. METHODS The charts of all patients with ocular involvement of non-Hodgkin’s lymphoma followed during the period 1984–93 were reviewed. The diagnosis of non-Hodgkin’s lymphoma was made by different diagnostic approaches: CNS biopsy, anterior chamber tap, vitrectomy, haematology, and necropsy. RESULTS Eight patients had oculocerebral large cell and one had small cell non-Hodgkin’s lymphoma. Five patients with pure ocular localisation had initially received steroid treatment for intermediate uveitis. First diagnosis was made on CNS biopsy in three, anterior chamber tap in one, vitreous aspirate in three, haematology in one, and necropsy in one case. CONCLUSION Ocular non-Hodgkin’s lymphoma is a difficult diagnosis. Vitrectomy allows cytological diagnosis in most but not all cases. When no treatment is given, patients survive for only a few weeks once the CNS is involved. Although the disease is eventually fatal, treatment by means of radiotherapy, steroid administration, and vitrectomy can allow these patients to lead a normal professional and social life during the years between recurrences.

CLINICAL-STUDY OF TICLOPIDINE IN DIABETIC-RETINOPATHY.

In this multicentre double-blind study, 100 insulin-treated diabetics with background retinopathy were randomly assigned to treatment with either 250 mg ticlopidine b.i.d. (49 patients) or placebo (51

Diabetes mellitus and the eye.

Abstract In Belgium as in other industrialized countries, diabetic retinopathy is still the most important cause of blindness in the active population group, but can be prevented by an early and adequate treatment. This highly socio-economic problem should therefore have priority with the autorities of the Belgian Health Department. The costs of a well-organized screening programme of the diabetic population are far less than the costs that arise from the economic and social consequences caused by irreversable visual loss, the costs of long and expensive treatments and long periods of inability to work, when advanced diabetic eye disease has developed. Guidelines for management and timely treatment of patients with diabetic retinopathy are available, but should be implemented more vigorously.