{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T23:06:30Z","timestamp":1779231990827,"version":"3.51.4"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Most vitreo-retinal lymphoma are rare high-grade B cell lymphoma of immune privileged sites. As there is considerable heterogeneity, the clinical management hampers the optimisation of treatment protocols. While most patients respond to a fixed intravitreal dose of 400\u2009\u00b5g, corneal toxicity is seen in 20 to 50% of patients when administered at short intervals under 1 month. Local recurrence of disease is also seen in about 20% of patients. While systemic chemotherapy is weight or surface dependent, most intraocular treatment protocols follow a fixed dose regimen. By analysing existing published data, we show that both experimentally and clinically, the elimination of intraocular methotrexate follows a first order kinetic model. Starting with an initial concentration of 100\u2009\u00b5g\/ml of vitreous volume, in most instances, a therapeutic level is present for 3 to 5 days. Systemic therapy alone does not achieve these sustained ocular levels. Furthermore, with vitreous volumes which\n          can vary between 3 and 10\u2009ml, using a fixed Mtx dose can either lead to increased risk of toxicity or under treatment. Future treatment protocols should make use of fixed initial concentrations rather than a fixed dose, thus allowing a better comparison of outcomes. Formulas to adjust the concentration of Mtx to be delivered in a fixed volume are provided.<\/jats:p>","DOI":"10.1055\/a-2788-0429","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:32:59Z","timestamp":1768437179000},"page":"590-594","source":"Crossref","is-referenced-by-count":1,"title":["Intravitreal Management of Ocular Lymphoma Should Use Adjusted Drug Concentrations Not Fixed Dosages"],"prefix":"10.1055","volume":"243","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-5603","authenticated-orcid":false,"given":"Marc D.","family":"de Smet","sequence":"additional","affiliation":[{"name":"Ophthalmology, Helvetia Retina Associates, Lausanne, Switzerland"},{"name":"Retina, New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine, New York, United States"},{"name":"Ophthalmology, Universit\u00e9 Libre de Bruxelles Facult\u00e9 de M\u00e9decine, Brussels, 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