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Chichao Chan - One of the best experts on this subject based on the ideXlab platform.

  • Intraocular Lymphoma.
    Current opinion in ophthalmology, 2020
    Co-Authors: Chichao Chan, Ronald R Buggage, Robert B Nussenblatt
    Abstract:

    There are two distinct forms of Intraocular Lymphoma. One originates within the central nervous system (CNS) and is called primary CNS Lymphoma. The second form arises outside the CNS and metastasizes to the eye. When primary CNS Lymphoma initially involves the retina, it is named primary Intraocular Lymphoma (PIOL). Although PIOL is a rare malignancy, the incidence has dramatically increased in the past 15 years. Typical clinical manifestations include blurred vision and floaters. Ophthalmic examination reveals vitreitis and subretinal infiltrates. Diagnosis of PIOL can be difficult and requires neuroimaging, examination of the cerebrospinal fluid and/or vitreous. Molecular analysis detecting immunoglobulin gene rearrangements and ocular cytokine levels showing elevated interleukin (IL)-10 with an IL-10 to IL-6 greater than 1.0 are helpful adjuncts for the diagnosis. Treatment includes systemic chemotherapy and radiation with current regimens favoring the use of chemotherapy first. In contrast, metastatic systemic Lymphoma, like other metastatic ocular tumors, is usually confined to the uvea, in particular the choroid. Compared with PIOL, metastatic systemic Lymphomas have a much lower prevalence, better prognosis, and are less likely to create a diagnostic dilemma.

  • CurrentConceptsinDiagnosingandManaging PrimaryVitreoretinal(Intraocular)Lymphoma
    2020
    Co-Authors: Chichao Chan
    Abstract:

    Primary vitreoretinal Lymphoma (PVRL), previously called primary Intraocular Lymphoma (PIOL), is a rare and fatal ocular malignancy. PVRL is a subset of primary central nervous system lym - phoma (PCNSL), mostly a diffuse large B-cell lym - phoma. The diagnosis of PVRL is often challenging as it often masquerades as chronic uveitis. PVRL requires invasive procedures for tissue diagnosis. Cytology/pathology, molecular pathology (immuno- globulin or T-cell receptor gene rearrangement), immunohistochemistry, biophysical technology (flow cytometry), and cytokine analysis (inter - leukine-10) are often required. The therapies that have been successful in systemic Lymphomas have not been reliably effective in PVRL and PCNSL. Current management of PVRL involves aggressive chemotherapy (methotrexate and rituximab) and radiation therapy. PVRL normally responds well to initial treatment; however, relapse rate and CNS involvement are high, resulting in poor prognosis and limited survival. A professional team of medical experts in ophthalmology, oncology (particularly neuro-oncology), and pathology is essential for opti - mizing patient management. (Discovery Medicine

  • Intraocular Lymphoma models
    Ocular Oncology and Pathology, 2015
    Co-Authors: Mary E Aronow, Defen Shen, Jacob Hochman, Chichao Chan
    Abstract:

    Primary vitreoretinal Lymphoma (PVRL) is a subtype of primary central nervous system Lymphoma (PCNSL), a high-grade, extranodal, non-Hodgkin's Lymphoma, predominantly of B-cell origin. PVRL is an aggressive disease with a poor prognosis. Human studies are not ideally suited for the study of Intraocular Lymphoma pathogenesis or treatment strategies due to the rare nature of the disease, its variable presentation, limited volume of available ocular fluids, and fragility of sampled Lymphoma cells. Animal models have been critical in making progress in understanding Intraocular Lymphoma pathogenesis and investigating potential therapeutic strategies. Early murine models for Intraocular Lymphoma used intraperitoneal injection of mouse T-cell Lymphomas. This was followed by intravitreal T-cell murine models. More recent murine models have used B-cell Lymphomas to more closely mimic human disease. The most current B-cell Lymphoma models employ a combined approach of inoculating both the mouse vitreous cavity and brain. The challenge in murine models for Intraocular Lymphoma lies in recreating the clinical features, disease behavior, molecular profile, systemic immunity, and the microenvironment observed in human disease. In the future, animal models will continue to be central to furthering our understanding of the disease and in the investigation of potential treatment targets.

  • fundus autofluorescence patterns in primary Intraocular Lymphoma
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Megan Casady, Robert B Nussenblatt, Lisa J Faia, Maryam Nazemzadeh, Chichao Chan
    Abstract:

    Purpose:To evaluate fundus autofluorescence (FAF) patterns in patients with primary Intraocular (vitreoretinal) Lymphoma.Methods:Records of all patients with primary Intraocular Lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were eval

  • the future of primary Intraocular Lymphoma retinal Lymphoma
    Ocular Immunology and Inflammation, 2009
    Co-Authors: Chichao Chan, Sylvain Fisson, Bahram Bodaghi
    Abstract:

    Basic science and clinical investigations in cancer research have contributed to our understanding of the genetic causes of various neoplasms and discovery of novel therapeutic interventions to fight malignancies such as Lymphoma. During this exciting time, we have witnessed the advent of new technologies to further characterize primary Intraocular Lymphoma (PIOL), or retinal Lymphoma, which is selected as the first “Disease of the Year” by Ocular Immunology and Inflammation. Differ ent comprehensive aspects of PIOL, including epidemiology, clinical manifestations, diagnosis, pathophysiology, therapy, and animal models are discussed. The future of PIOL holds an opportunity to really understand the unique cytologic, histopathologic, physiological and immunologic features, as well as the genotypic traits (gene expression, interaction, polymorphism, epigenetics, etc.) and epidemiology. This information will empower us to truly make a difference in patients’ managements with this devastating disease. While most of this technology already exists, much work still needs to be done to make translational therapy a reality for PIOL patients in the future.

Robert B Nussenblatt - One of the best experts on this subject based on the ideXlab platform.

  • Intraocular Lymphoma.
    Current opinion in ophthalmology, 2020
    Co-Authors: Chichao Chan, Ronald R Buggage, Robert B Nussenblatt
    Abstract:

    There are two distinct forms of Intraocular Lymphoma. One originates within the central nervous system (CNS) and is called primary CNS Lymphoma. The second form arises outside the CNS and metastasizes to the eye. When primary CNS Lymphoma initially involves the retina, it is named primary Intraocular Lymphoma (PIOL). Although PIOL is a rare malignancy, the incidence has dramatically increased in the past 15 years. Typical clinical manifestations include blurred vision and floaters. Ophthalmic examination reveals vitreitis and subretinal infiltrates. Diagnosis of PIOL can be difficult and requires neuroimaging, examination of the cerebrospinal fluid and/or vitreous. Molecular analysis detecting immunoglobulin gene rearrangements and ocular cytokine levels showing elevated interleukin (IL)-10 with an IL-10 to IL-6 greater than 1.0 are helpful adjuncts for the diagnosis. Treatment includes systemic chemotherapy and radiation with current regimens favoring the use of chemotherapy first. In contrast, metastatic systemic Lymphoma, like other metastatic ocular tumors, is usually confined to the uvea, in particular the choroid. Compared with PIOL, metastatic systemic Lymphomas have a much lower prevalence, better prognosis, and are less likely to create a diagnostic dilemma.

  • fundus autofluorescence patterns in primary Intraocular Lymphoma
    Retina-the Journal of Retinal and Vitreous Diseases, 2014
    Co-Authors: Megan Casady, Robert B Nussenblatt, Lisa J Faia, Maryam Nazemzadeh, Chichao Chan
    Abstract:

    Purpose:To evaluate fundus autofluorescence (FAF) patterns in patients with primary Intraocular (vitreoretinal) Lymphoma.Methods:Records of all patients with primary Intraocular Lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were eval

  • intravitreal methotrexate resistance in a patient with primary Intraocular Lymphoma
    Ocular Immunology and Inflammation, 2008
    Co-Authors: Chichao Chan, Robert B Nussenblatt, Gordon Byrnes, Robert N Fariss, Ronald Buggage
    Abstract:

    Purpose: To describe the clinical course of a patient with multiple recurrences of primary Intraocular Lymphoma (PIOL). Design: Interventional case report, Methods: Retrospective chart review. Results: A 57-year-old female treated with multiple intravitreal methotrexate injections became refractory to intravitreal methotrexate after a year. Lymphoma cells evaluated using immunocytochemistry and confocal microscopy showed aberrant multidrug resistance-related protein (MRP) and decreased reduced folate carrier (RFC) and folate binding protein (FBP) expression compared to PIOL cells from another patient clinically responsive to methotrexate. Conclusions: This case suggests that alterations in the transport of methotrexate across the cell membrane might contribute to resistance following repeated intravitreal injections.

  • diagnosis and management of primary Intraocular Lymphoma
    Hematology-oncology Clinics of North America, 2005
    Co-Authors: Grace A Levyclarke, Chichao Chan, Robert B Nussenblatt
    Abstract:

    Primary Intraocular Lymphoma (PIOL) is a subset of primary central nervous system Lymphoma. The incidence of PIOL has increased in the past 20 years. PIOL often presents as chronic uveitis that is resistant to corticosteroid therapy. Diagnosing PIOL can be challenging and requires an expert pathologist. The treatment of PIOL is difficult because of its high recurrence rate and refractory nature. The objective for the future is to improve diagnostic techniques and therapeutic success while minimizing ocular toxidties.

  • murine model of primary Intraocular Lymphoma
    Investigative Ophthalmology & Visual Science, 2005
    Co-Authors: Chichao Chan, Defen Shen, Robert B Nussenblatt, Maria R. Fischette, S.p. Mahesh, Jacob Hochman
    Abstract:

    PURPOSE. Primary Intraocular Lymphoma (PIOL) is a subtype of central nervous system Lymphoma. Although this Lymphoma is rare, its incidence has tripled in the past 15 years. Currently, the only available model is a murine metastatic malignant Lymphoma that occurs after intraperitoneal inoculation of Rev2-T-6 Lymphoma cells into newborn syngeneic mice. The current study was conducted to develop a new experimental model for PIOL. METHODS. Rev-2-T-6 cells (0.5 10 5 or 1.0 10 5 ) were inoculated into the vitreous of adult BALB/c mice. Mice were monitored clinically every other day and under fundoscopic examination weekly. They were euthanatized on weeks 3, 5, 6, 7, or 8, after inoculation. All eyes were processed for histology. Immunohistochemistry was performed with an antibody (p14) specific for Rev-2-T-6 cells. Cytokine mRNA expression (IL-2, -4, -6, -10, and IFN- and CC chemokine receptor-1 [CCR1]) was assayed in the Lymphoma cells by microdissection and RT-PCR. IL-10 and -6 levels in the vitreous were measured by ELISA. RESULTS. Within 2 to 4 weeks, tumor cells from the vitreous migrate through the retina and gather between the RPE cell and retina. Rarely (2 months after inoculation), Rev-2-T-6 cells may break through the RPE and infiltrate the choroid and sclera. Tumor localization was confirmed by immunohistochemistry. The Intraocular Lymphoma cells produce high levels of IL-10, IFN-, and CCR1 transcripts. A high level of IL-10 was detected in the vitreous inoculated with Rev-2-T-6 cells. CONCLUSIONS. The data suggest that RPE cells constitute a barrier to the spread of Intraocular Lymphoma. Intravitreal injection of Rev-2-T-6 cells is a novel model of PIOL in immunecompetent hosts that will aid in understanding the molecular mechanisms of the disease. (Invest Ophthalmol Vis Sci. 2005; 46:415‐419) DOI:10.1167/iovs.04-0869

Sarah E. Coupland - One of the best experts on this subject based on the ideXlab platform.

Takeshi Naito - One of the best experts on this subject based on the ideXlab platform.

Diana V Do - One of the best experts on this subject based on the ideXlab platform.