Chemotherapy is the mainstay treatment for eye lymphoma. Treatments can be local (injected directly into the eye) or systemic (given orally or injected into a vein, under the skin, or into the cerebrospinal fluid).
Local chemotherapy includes methotrexate or rituximab injected directly into the vitreous humor. Methotrexate is a powerful drug that kills cancer cells. At lower dosages, it’s used to treat inflammatory autoimmune conditions such as rheumatoid arthritis and psoriasis.
Rituximab is a monoclonal antibody that targets and attaches to a protein found on the surface of B cells. This is toxic to B cells and results in their death.
Eye lymphoma has also been known to respond to external beam radiation, according to the American Academy of Ophthalmology. This is a treatment that aims radiation at a specific part of the body (in this case, your eye or eyes) to kill cancer cells.
Systemic treatment affects your whole body. For systemic chemotherapy, you may get methotrexate and rituximab, as you would with local treatment. The difference is how they’re delivered — either orally or injected into a muscle, a blood vessel, your spinal cord, or under your skin. Other powerful anticancer medications used to treat eye lymphoma include:
- Etoposide (Toposar, Etopophos)
- Lenalidomide (Revlimid)
- Temozolomide (Temodar)
If your doctors are recommending a second radiation method beyond local external beam radiation, it will probably be whole brain radiation, according to the American Academy of Ophthalmology. Whole brain radiation is usually helpful when eye lymphoma has spread to the brain, which happens in many people, according to some research.