Objective To observe the clinical characteristics of patients with systemic intraocular lymphoma (IOL). Methods A retrospective clinical study. From January 2016 to December 2024, 14 patients (23 eyes) who were diagnosed with system-IOL at Beijing Tongren Hospital, Beijing Intech Aier Eye Hospital, and Beijing Aier Eye Hospital were included in the study. Data on medical history, pathological subtype, ocular manifestations, treatment, and clinical outcomes were collected. The clinical features, therapeutic approaches, and prognosis were retrospectively analysed. The 1-year survival rate after ocular involvement was estimated using the Kaplan-Meier method. Results Among the 14 patients, 5 were male and 9 were female, with a mean age of (57±9) years. Nine patients, involving 14 eyes, had a confirmed history of systemic lymphoma before the onset of IOL, whereas 5 patients, involving 9 eyes, initially presented with ocular symptoms and were subsequently found to have concomitant systemic lymphoma. Systemic lesions involved the lymph nodes, breast, adrenal gland, testis, spine, nasal region, gingiva, chest wall, and submandibular mass in 4, 2, 2, 1, 1, 1, 1, 1, and 1 patient, respectively. Diffuse large B-cell lymphoma (DLBCL) and natural killer/T-cell lymphoma were identified in 11 and 3 patients, respectively. One patient had composite lymphoma, with ocular DLBCL and systemic natural killer/T-cell lymphoma; the pathological subtype of systemic and ocular lymphoma was concordant in 13 patients. The interval from systemic lymphoma to ocular involvement was 4.2 (1, 14) years. Among the 23 eyes, keratic precipitates were observed in 13 eyes (56.5%, 13/23), varying degrees of anterior chamber inflammation in 11 eyes (47.8%, 11/23), and vitreous opacity in all 23 eyes (100.0%, 23/23). Vitreous infiltration was the predominant manifestation in 4 eyes (17.4%, 4/23), whereas retinal infiltration was observed in 19 eyes (82.6%, 19/23). Systemic treatment included systemic chemotherapy, local radiotherapy, chimeric antigen receptor T-cell therapy, and autologous stem cell transplantation. Intravitreal chemotherapy was administered to 8 patients involving 14 eyes. After treatment, regression of ocular lesions and improvement in visual acuity were observed in 11 eyes. Visual acuity decreased in 2 eyes, including 1 eye with optic nerve infiltration and 1 eye in a patient with newly detected systemic lesions. Among the 14 patients, 3 were lost to follow-up and 2 died. The 1-year survival rate after ocular involvement was 84.6%. Conclusions DLBCL is the most common pathological subtype of systemic-IOL, followed by T-cell lymphoma. Ocular involvement in systemic-IOL may also present as a vitreoretinal pattern, characterised by vitreous opacity and retinal infiltration, with a relatively high proportion of anterior segment inflammation. Intravitreal chemotherapy may effectively induce regression of intraocular lesions and improve visual acuity. In cases with suboptimal treatment response, newly developed ocular lesions and systemic disease progression should be carefully considered.

Citation： Zhou Suowang, Guan Wenxue, Zhang Xu, Peng Xiaoyan. Clinical characteristics of intraocular lymphoma associated with systemic lymphoma. Chinese Journal of Ocular Fundus Diseases, 2026, 42(6): 512-518. doi: 10.3760/cma.j.cn511434-20250727-00324 Copy

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