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Table 1 Review of cases, interventions, and outcomes of benign reactive lymphoid hyperplasia conjunctival lesions

From: Bilateral benign reactive lymphoid hyperplasia of the conjunctiva: a case treated with oral doxycycline and review of the literature

Author

Number of patients

Age in years (n)

Laterality (n)

Location (n)

Treatment modality (n)

Recurrence (n)

Follow up (months)

Response (n)

Parikh et al. (2018) [29]

1

66

Bilateral

Bulbar conjunctiva

Topical cyclosporine 0.05%

None

3

Partial

Moraes et al. (2017) [14]

1

40

Unilateral

Bulbar conjunctiva

Topical corticosteroids

None

36

Complete

Shields et al. (2017) [8]

Shields et al. (2004) [9]

Shields et al. (2001)a [1]

113

Mean: 43.2

Range: 5.3–86.3 age 0–30, (41) age 31–60, (30) age > 60, (36)

N/A

Fornix (34), Tarsal conjunctiva (6), Plica (15), Caruncle (8), Diffuse (1), Limbal bulbar conjunctiva (13), Extralimbal bulbar conjunctiva (30)

Topical corticosteroids (18), Excision (67), External Beam Radiotherapy (7), Observation (21)

Systemic lymphoma (1)

N/A – survey over 40 years

N/A

Nivean et al. (2017) [19]

1

17

Unilateral

Nasal conjunctiva

Excision followed by oral corticosteroids

None

24

Partial

AlAkeely et al. (2017) [6]

24

Mean: 11.6

Range: 7–17

Unilateral(15) Bilateral (9)

Bulbar conjunctiva, nasally (23) and laterally (1)

Primary excision (17), Topical corticosteroids (4) or topical antihistamines (2) or topical antibiotic (1) followed by excision

1 patient at 1 yr. & 1 patient at 2 yrs. postoperatively, both post-excision

Mean: 49

Range: 12–98

Complete (17), Partial (7)

Vaivanijkul et al. (2017) [37]

1

5

Unilateral

Bulbar conjunctiva

Incisional biopsy & Observation (EBV-related lesion)

None

2

Complete

Brazert et al. (2015) [18]

1

14

Unilateral

Bulbar conjunctiva

Oral methylprednisolone

None

32

Complete

Beykin et al. (2014) [28]

7

Mean: 13.6

Range: 6–21.5

Unilateral (6) Bilateral (1)

Plica semilunaris/caruncle

Excision

None

Mean: 72

Range: 20–168

Complete

Koay et al. (2012) [26]

1

50

Bilateral

Bulbar conjunctiva/Cornea

Excision

None

12

N/A

Herwig et al. (2012) [10]

7

Median: 23

Range: 8–77

Unilateral (4) Bilateral (2)b

Caruncle (2), Plica (1), Inferior fornix (1), Nasal conjunctiva adjacent to plica (3)

Excision

None

Range: 12–132

N/A

Al-Mujaini et al. (2012) [27]

2

9 and 14

Unilateral

Nasal conjunctiva close to plica & medial canthus, respectively

Excision

None

Range: 9–10

Complete

Fukuhara et al. (2012)c [12]

1

35

Bilateral

Upper and lower conjunctival fornix

Observation

Conjunctival lymphoma

11

N/A

Ahmed et al. (2011) [16]

1

70

Unilateral

Superomedial conjunctival quadrant

Intralesional steroids (triamcinolone acetonide)

None

N/A

Complete

Lam et al. (2011) [25]

1

13

Bilateral

Bilateral nasal bulbar conjunctiva adjacent to plica

Excision

None

6

Partial

Oh DH et al. (2011) [31]

1

27

Bilateral

Nasal conjunctiva

Anti-VEGF subconjunctival injection (Bevacizumab)

None

12

Complete

Stacy et al. (2010) [4]

6

Median: 40

Range:8–77

Unilateral (5) Bilateral (1)

Inferior formix (1), Inferolateral bulbar conj (1), Superonasal bulbar conj (1), Bilateral medial bulbar conj (1), Plica/caruncular complex (2)

Excision

None

Range: 1–36

N/A

Bagheri et al. (2007) [7]

5

Mean: 14

Range: 6–18

Unilateral (5)

Caruncle lesions (3), plica semilunaris (2)

Excision

None

Mean: 45.8

Range: 2–108

Complete

Finger et al. (2007) [30]

1

33

Bilateral

Superior tarsal conjunctiva and inferior fornix

Topical Interferon 1 MIU/mL

None

6

Partial

Reddy et al. (2006) [20]

1

31

Unilateral

Plica and caruncle

Excision

None

24

Complete

Ioannidis et al. (2005) [15]

1

59

Bilateral

Superotemporal conjunctiva

Topical dexamethasone (Maxitrol)

None

N/A

Partial

Telander et al. (2005) [17]

1

72

Unilateral

Nasal conjunctiva

Subconjunctival steroid injection (triamcinolone acetonide)

None

9

Complete

Rofail et al. (2005) [23]

1

73

Unilateral

Superotemporal conjunctiva

Excision

None

1

N/A

Kim et al. (2005) [24]

1

14

Bilateral

Bulbar conjunctiva, near the medial canthus

Excision

None

24

Complete

Tang et al. (2003) [32]

1

13

Unilateral

Caruncle, plica, and superomedial bulbar conjunctiva

Incisional biopsy & Observation (spontaneous resolution along with patient’s EBV-negative tonsillar enlargement)

None

24

Complete

Mannami et al. (2001) [33]

1

78

Unilateral

N/A

Observation

N/A

Lost to follow up

N/A

Hundsdoerfer et al. (2000) [22]

1

12

Unilateral

Nasal conjunctiva

Incisional biopsy & Observation (EBV-related lesion)

None

8

Complete

Feinberg et al. (2000) [38]

2

19 and 8

Bilateral and Unilateral

Medial canthus/caruncle/plica & Inferior conjunctiva, involving the fornix and extending into the caruncle, respectively

Incisional biopsy & Observation (19 yo patient), Excision (8 yo patient) – Both patients had EBV-related lesions

None

24

Complete

McLeod et al. (1999) [5]

2

12 and 7

Unilateral

Nasal bulbar conjunctiva with involvement of the adjacent semilunar fold & Left caruncle, inferior fornix, respectively

Excision (both patients) followed by oral corticosteroids (7 yo patient)

None

12 and 42

Partial

Coupland et al. (1998) [2]

3

14, 32 and 35

N/A

Conjunctiva

Topical corticosteroids

1 patient after 5 years

Median: 31.3

Range:6.4–125.5

Partial

Urbak et al. (1993) [36]

1

14

Unilateral

Nasal bulbar conjunctiva

Observation (EBV-related lesion)

None

2

Complete

Gardner et al. (1991) [34]

1

38

Unilateral

Superonasal conjunctiva

Observation (EBV-related lesion)

None

12

Complete

Knowles et al. (1990) [21]

9

Median: 61

Range: 17–93

N/A

N/A

Excision

N/A

N/A

N/A

Meisler et al. (1981) [35]

1

11

Unilateral

Upper tarsal conjunctiva

Observation (EBV-related lesion)

None

1

Complete

Sigelman et al. (1978) [11]

33

Median: 55

Range: 9–78

Unilateral (26)

Bilateral (7)

Inferior fornix (15), Bulbar conjunctiva (12), Plica/caruncle (4)

Excision (13), Excision & Corticosteroids (1), Excision & External Beam Radiotherapy (13), External Beam Radiotherapy (4), Observation (2)

7 patients (excision: 3, excision & corticosteroids:1, excision & irradiation: 2, irradiation: 1)

72

Complete

  1. EBV = Epstein-Barr virus; N/A = Information not available or not applicable
  2. a In this series, one patient with BRLH developed systemic lymphoma
  3. b In this study, in both bilateral cases the other eye was already diagnosed with conjunctival lymphoma
  4. c This patient developed extra-nodal marginal zone (EMZL) B cell lymphoma from BRLH in her right eye 11 months after diagnosis of EMZL in her left eye