The surgical management of patients with intraocular inflammation is a particular challenge. In fiscal year 1995, our efforts were directed mainly to the study of diagnostic and therapeutic modalities for intraocular non-Hodgkin's lymphoma. This particular tumor is unusual as it is found only in the brain and in the eye. Systemic dissemination occurs only as a late manifestation. Diagnosis is often delayed and can be made reliably only after carefully planning surgery, coordinating it with cytopathology so that the specimen can be rapidly processed. Avoidance of the use of steroids to treat patients shortly before they undergo a vitrectomy can be of use, particularly if few malignant cells are anticipated in the specimen. For strictly ocular disease, radiotherapy still remains the norm. However, in cases of combined ocular and brain involvement, patients have recently been treated with an intense systemic and intrathecal treatment that appears capable of placing patients in long-term remission. We have also treated a patient with an aggressive recurrence of ocular lymphoma following chemotherapy and radiotherapy. This patient received intravitreal treatment that resulted in remission of the recurrence of the lymphoma that was not controlled with systemic chemotherapy alone.
