[Retrobulbar optic neuropathy and non-Hodgkin lymphoma]

Area of Science:

• Ophthalmology
• Neurology
• Hematology

Background:

• Non-Hodgkin lymphomas (NHLs) are diverse cancers affecting lymphatic tissues.
• Ocular lymphomas represent 1% of NHLs, with orbital tumors being the most common presentation.
• Primary infiltration of the optic nerve and its sheath by lymphoma is exceptionally rare.

Observation:

• A 51-year-old female with NHL, in remission after chemotherapy, presented with sudden right visual loss.
• Examination revealed a right afferent pupillary defect, and MRI showed optic nerve infiltration.
• Cerebrospinal fluid analysis confirmed lymphomatous meningitis, leading to a diagnosis of lymphomatous optic neuropathy (LON).

Findings:

• Sudden, painful visual loss in a cancer patient can indicate lymphomatous optic neuropathy (LON).
• Diagnosis is confirmed via MRI and cerebrospinal fluid analysis.
• LON can be the sole ocular manifestation of disease recurrence in patients with systemic NHL in remission.

Implications:

• This case underscores the importance of considering LON in patients with a history of NHL presenting with visual disturbances.
• Early diagnosis and intervention are crucial for managing this rare but serious complication.
• LON recurrence may occur in the absence of other systemic disease signs, necessitating thorough ocular and neurological evaluation.