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Middle East Afr J OphthalmolMEAJOMiddle East African Journal of Ophthalmology0974-92330975-1599Medknow Publications India MEAJO-17-390bLetters to EditorAuthors' reply Omoti Afekhide E. Omoti Caroline E. 1Momoh Rita O. Department of Ophthalmology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State, Nigeria1 Department of Haematology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State, NigeriaCorresponding Author: Dr. Afekhide E. Omoti, Department of Ophthalmology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State, Nigeria. E-mail: kaitlyn41@example.com 2010 17 4 390 391 © Middle East African Journal of Ophthalmology2010This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Ophthalmic Disorders in Adult Lymphoma Patients
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Sir,

We thank the authors of this letter for their keen interest on our article. However, we still believe that most of the published work on this topic involves only case reports or small case series.12 The authors have listed a handful of studies that were large series out of the hundreds of publications available on the topic in peer reviewed literature. Of note, is that we did not state that there is a complete lack of studies that included large numbers. We encourage only studies on large sample sizes patients that would accurately reflect issues surrounding this disease. Moreover, we also encourage studies from an alternate viewpoint and agree that they would be of interest to ophthalmologists. Two such studies were conducted by Shields et al.3 and Demirci et al.4 however what was reported by them was not the primary focus of our study.

Patients undergoing chemotherapy were excluded because this treatment can cause ocular complications which may cause confusion in deciding whether lesions were due to either lymphoma or treatment.5 We concur that it is possible for lymphoma patients to present with features of hemorrhages and vasculitis, but that the more likely presentation would be in the form of confluent, round, or geographic greasy-yellow sub-RPE infiltrates. Such features were not found in any of the subjects of our study cohort. Perhaps there may be racial differences in Black African patients or that the small number of subjects with lymphoma may have affected the outcomes.

We acknowledge the assistance of the resident doctors in the Department of Haematology and Ophthalmology of the University of Benin Teaching Hospital, Benin City, Nigeria in data collection.
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REFERENCES
1 Omoti AE  Omoti CE  Momoh RO   Ophthalmic disorders in adult lymphoma patients in Africa Middle East Afr J Ophthalmol 2009 16 252 5 20404992 
2 Omoti AE  Omoti CE   Ophthalmic manifestations of lymphoma Ann Afr Med 2007 6 89 93 18240494 
3 Shields CL  Shields JA  Carvalho C  Rundle P  Smith AF   Conjunctival lymphoid tumors: Clinical analysis of 117 cases and relationship to systemic lymphomas Ophthalmology 2001 108 979 84 11320031 
4 Demirci H  Shields CL  Shields JA  Honavar SG  Mercado GJ  Tovilla JC   Orbital tumors in older adult population Ophthalmology 2002 109 243 8 11825802 
5 Omoti AE  Omoti CE   Ocular toxicity of systemic anticancer chemotherapy Pharm Pract 2007 4 55 9


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