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Optic neuropathy in chronic lymphocytic leukemia
J N Currie1, S Lessell, I M Lessell
1Neuroophthalmology Section, National Eye Institute, Bethesda, Md.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 1, 1988
Summary
Ophthalmic involvement, specifically optic nerve infiltration causing vision loss, can be an early sign of chronic lymphocytic leukemia (CLL). This study highlights three cases where early CLL led to optic nerve damage, successfully treated with irradiation.
Area of Science:
- Ophthalmology
- Neurology
- Hematology
Background:
- Ophthalmic and neurologic involvement in chronic lymphocytic leukemia (CLL) is typically a late-stage complication.
- Early clinical manifestations of CLL are often subtle and non-specific.
Observation:
- Three patients presented with progressive visual loss due to optic nerve infiltration as an initial symptom of CLL.
- Symptoms included progressive optic atrophy, reduced visual acuity, and visual field defects.
- One patient experienced transient visual obscurations and disc edema preceding optic atrophy.
Findings:
- Cerebrospinal fluid lymphocyte surface marker studies aided in distinguishing leukemic optic nerve infiltration from other optic neuropathies.
- Optic nerve irradiation resulted in significant clinical improvement for all three patients.
Implications:
- This suggests that unexplained optic nerve damage may warrant investigation for early-stage CLL.
- Early diagnosis and intervention, such as optic nerve irradiation, can lead to improved visual outcomes in these rare cases.
- Highlights the importance of considering hematologic malignancies in the differential diagnosis of optic neuropathies.