Effectiveness and safety of treatments for new-onset, refractory and relapsed vitreoretinal lymphoma: protocol for a systematic review and network meta-analysis
Year: 2026
Type: review
Study design: Study Protocol
Abstract: ABSTRACT: INTRODUCTION: Vitreoretinal lymphoma (VRL) is a rare intraocular malignancy. It has a poor prognosis because, despite a range of therapeutic approaches, central nervous system (CNS) lymphoma may arise at any stage. Because of the rarity of VRL, intervention studies that attempt to define optimal treatment, especially for refractory or relapsed disease, are small and dominated by retrospective and observational designs. Many treatment regimens are associated with substantial toxicity. A systematic review protocol has been developed to examine the existing literature on the effectiveness and safety of VRL-directed therapies in patients with newly diagnosed, refractory and relapsed cancer. METHODS AND ANALYSIS: Comprehensive literature searches will identify studies reporting on the treatment of VRL from four electronic bibliographic databases (Ovid MEDLINE, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials), in addition to the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov, from the year 2000. Reference lists of included studies will also be screened. There will be no language restrictions. Studies that enrolled men and women of any age with VRL (new-onset, refractory and relapsed), including both primary VRL and VRL with past or concurrent CNS involvement, will be included. The systematic review will encompass all VRL-directed ocular and systemic interventions evaluated in randomised controlled trials and observational studies. Studies that evaluated treatment of CNS lymphoma without ocular involvement, ocular cancers other than VRL, and inflammatory ocular diseases, studies that used topical medications only and experimental studies that employed animal models will be excluded. Two authors will independently screen titles and abstracts, followed by full-text eligibility assessment. Included studies will undergo data extraction and independent risk-of-bias assessment, with certainty of evidence appraised using the Grading of Recommendations Assessment, Development and Evaluation approach. A network meta-analysis will compare interventions directly or indirectly, as the data allow. ETHICS AND DISSEMINATION: Ethical approval is not required for the review as it relies on previously conducted studies. The findings will be disseminated in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD420251251269
Source: BMJ Open
Institutions: Flinders University, The University of Melbourne
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7220918144