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Leukemic occult infiltrative optic neuropathy presenting as optic neuritis: a case report
Fengsheng Xu1, Yuan Wu2, Yingzi Pan3
1Department of Ophthalmology, Peking University First Hospital, No.8 Xi Shi Ku Street, Xi Cheng District, Beijing, 100034, China.
BMC Ophthalmology
|October 9, 2024
Summary
Isolated ocular leukemia relapses are rare. This case highlights optic nerve infiltration without initial MRI evidence, emphasizing radiation therapy
Area of Science:
- Hematology
- Ophthalmology
- Neurology
Background:
- Isolated ocular relapses of leukemia are uncommon, typically manifesting as optic nerve infiltrative lesions.
- Early detection and management are crucial for favorable outcomes.
Observation:
- A 33-year-old female presented with optic neuritis, an isolated ocular relapse of leukemia.
- Leukemic infiltration of the optic nerve was initially occult, with no MRI abnormalities.
- Intrathecal chemotherapy provided temporary resolution, but non-compliance led to disease progression.
Findings:
- The case demonstrates the progression of leukemia optic nerve infiltration from occult to overt lesions.
- Leukemic optic nerve infiltration can occur without detectable MRI abnormalities.
- Radiation therapy is critical for managing infiltrative optic nerve lesions in leukemia.
Implications:
- This case underscores the importance of considering leukemic infiltration in optic neuropathy, even with negative imaging.
- It highlights the limitations of solely relying on MRI for diagnosing leukemic optic nerve involvement.
- Radiation therapy should be strongly considered for sustained control of these rare but aggressive ocular leukemic relapses.
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