What radiation treatment volume and dose would you deliver to an isolated DLBCL relapse in the left eye s/p vitrectomy and intraocular methotrexate?

This is a case of secondary ocular lymphoma but the management of primary ocular lymphoma may be helpful to consider. For patients with primary ocular lymphoma, a significant number of patients present with bilateral disease at initial diagnosis or will relapse in the contralateral eye after unilateral treatment (Teckie and Yahalom, PMID 23822539). Therefore, when I treat a patient with primary ocular lymphoma with radiation therapy (whether definitive or consolidation), I treat both eyes, even if the disease seems to be isolated to a single globe. This approach not only addresses potential microscopic disease in the contralateral eye but also decreases the risk of complications.

The primary side effect of 30-36 Gy to the eye is dry eye synd...