Program Book

IgG λ type (stage IIIA) in 2000. He was first managed with vincristine,
adriamycin and dexamethasone, resulting in partial response (PR), and
then with cyclophosphamide and dexamethasone, resulting in complete
response (CR), followed by autologous stem cell transplantation.
No M-component was detected until May 2008, when a solitary
plasmocytoma of the humerus appeared and was managed with
thalidomide. Soon thereafter, a new, diffusely infiltrating unilateral iris
lesion developed.
Results. At diagnosis the patient was asymptomatic with 20/20 vision,
IOP 14 mmHg, and cells in the anterior chamber. The iris was diffusely
reddish with a circle of pigment epithelial cysts around the pupillary
margin. The fundus was normal. He received two courses of bortezomib,
a reversible proteasome inhibitor, with dexamethasone. After the 1st
course, the cells and the redness of the iris disappeared. Two months
after the 2nd course of bortezomib, while on lenalidomide maintenance
therapy, he continued to be asymptomatic with an IOP of 14 mmHg and
a normal iris.
Conclusions. Bortezomib was effective in eradicating an intraocular
replase of multiple myeloma in a patient who previously had received
several types of conventional chemotherapy.
Financial disclosure. None
1923 OTp107
TUBEROUS SCLEROSIS COMPLEX: CHARACTERIZA-
TION OF OCULAR MANIFESTATIONS AND CORRELA-
TIONS WITH SYSTEMIC DISEASE
M.E. Turell1, E.I. Traboulsi1, A. Gupta2 , A.D. Singh1 (turellm2@ccf.org)
1. Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
2. Department of Pediatric Epilepsy, Cleveland Clinic Foundation,
Cleveland, OH
Purpose. To evaluate genotype/phenotype correlations in individuals
with astrocytic hamartoma (AH) and retinal achromic patch (AP) in the
setting of tuberous sclerosis complex (TSC).
Methods. Participants included 132 patients from the Cleveland Clinic
Foundation Tuberous Sclerosis Program (CCF-TSCP) and 907 patients
from the TSC Alliance (TSC-A). Gender, age at TSC diagnosis, presence
of TSC1 or TSC2 mutations, ophthalmic examination, and systemic
manifestations were analyzed.
Results. No difference was found in the prevalence of AH in the CCF-
TSCP (36.1%) and TSC-A (34.1%) groups (p = 0.743). AH were bilateral
in 43.3% and 18.1% (p = 0.009) and multiple in 40.0% and 15.3% (p =
0.008) in the CCF-TSCP and TSC-A groups respectively. In the CCF-TSCP
group, AP was observed in 12.0% of patients (40.0% bilateral, 50.0%
multiple). The presence of retinal features was associated with giant cell
astrocytoma (37.1% vs 14.6%; p = 0.018), renal angiomyolipoma (60.0%
vs 27.1%; p = 0.003), cognitive impairment (77.1% vs 43.8%; p = 0.002),
and epilepsy (91.4% vs 70.8%; p = 0.022) in those with and without
retinal findings respectively. In patients with retinal findings in the CCF-
TSCP and TSC-A groups, mutations in TSC2 were more frequent than
in TSC1, 3.3 times and 5.8 times, respectively. In those without retinal
findings; the relative rates were 0.67 times and 2.3 times, respectively.
Conclusions. Individuals with retinal findings are more likely to have
subependymal giant cell astrocytomas, renal angiomyolipomas,
cognitive impairment and epilepsy. TSC2 mutations are more frequent
in patients with retinal findings than in those without.
Financial disclosure. None
EYELID, CONJUNTIVA & ORBIT
Abstract Posters
88
Support: Research to Prevent Blindness
Challenge Grant, Department of
Ophthalmology, Cleveland Clinic Lerner
College of Medicine
248 OTp108
INTERLEUKIN LEVELS IN AQUEOUS OF UNTREATED
AND TREATED EYES WITH VITREORETINAL LYMPHO-
MA
Jose S. Pulido, MD, Joseph Balsanek, Brian Peters, Melissa Snyder, PhD
(pulido.jose@mayo.edu)
Department of Ophthalmology, Department of Laboratory Medicine and
Pathology
Purpose. To determine the levels of interleukin levels in aqueous
samples taken at the time of intravitreal treatment in patients with
vitreoretinal lymphoma
Methods. Samples at the time of paracentesis were immediately placed
on ice and then ELISA for interleukin levels were performed
Results. 81 samples were tested. IL 10 levels had a mean of 62 with
range of 0.69-624 pg/ml. IL-6 had a mean 123 pg/ml with range from
1.67-960 pg/ml. Other levels that were elevated included were MCP-
1,and IL-1ra.
Conclusions. There are marked changes in interleukin levels depending
upon treatment levels. IL-10 aqueous levels is a good measure of
treatment response to intravitreal chemotherapeutic agents
Financial disclosure. None
304 OTp109
INTRAVITREAL RITUXIMAB FOR PRIMARY INTRAOCU-
LAR LYMPHOMA (PIOL)
V. Kakkassery1, G. Willerding1, K. Jahnke2, A. Korfel2, U. Pleyer1, N.
Stübiger1, A.M. Joussen1 (vk@charite.de)
1. Department of Ophthalmology, Charité, Berlin, Germany
2. Department of Hematology and Oncology, Campus Benjamin Franklin,
Charité, Berlin, Germany
Purpose. PIOL is a rare manifestation of primary central nervous system
lymphoma (PCNSL). Due to its rarity, the optimal treatment of this
condition has not yet been defined thus far. The chimeric monoclonal
CD20 antibody rituximab offers a new intravitreal treatment option for
PIOL. Here, we report on the clinical course after repeated intravitreal
injections of rituximab for PIOL.
Methods. Diagnosis of PIOL was confirmed by clinical investigation
and vitreous biopsy in three cases. Two patients were pretreated with
systemic chemotherapy for their PCNSL (ifosfamide or MTX). Ocular
clinical findings (visual acuity, intraocular pressure, vitreous haze, extent
of tumor) were recorded before and after rituximab therapy. Intravitreal
1mg/0,1mL rituximab injections were conducted in accordance with the
German Ophthalmic Society guidelines for intravitreal injections. Data
were implemented in a nationwide open registry for PIOL supported by
the German Federal Ministry of Education and Research.
Results. Five eyes from 3 patients received a minimum of one to a