Leukemic involvement of the optic nerve

We studied five cases of leukemia with invasion of the optic disk and optic nerve. Two patients had acute lymphoblastic leukemia and three had acute myelogenous leukemia. All patients received intrathecal injections of chemotherapeutic drugs including methotrexate, cytarabine, and prednisolone. Three patients underwent irradiation therapy of the whole brain and optic nerve. While initial improvement in the ophthalmic abnormalities, such as optic disk edema, flame-shaped retinal hemorrhages, and dilation of the retinal vein, was noted, optic atrophy was later found in all eyes.