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A diagnostic challenge: chronic myelomonocytic leukaemia and recurrent anterior ischaemic optic neuropathy

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Abstract

We report the first case of ischaemic optic neuropathy (ION) linked to chronic myelomonocytic leukaemia (CMML) and its associated vasculitis. We discuss the link between CMML and vasculitis and the evidence suggesting it can cause anterior ischaemic optic neuropathy through a vasculitic process. We highlight the difficulty and delay in diagnosis as the use of steroids masked an underlying systemic process. Recurrent ION and raised inflammatory markers should raise suspicion of vasculitis. Together with an elevated monocyte but low platelet count, CMML should be considered.

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Abbreviations

AION:

Anterior Ischaemic Optic Neuropathy

A-AION:

Arteritic-Anterior Ischaemic Optic Neuropathy

VR-AION:

Vasculitis Related-Anterior Ischaemic Optic Neuropathy

CMML:

Chronic Myelomonocytic Leukaemia

NA-AION:

Non-Arteritic Anterior Ischaemic Optic Neuropathy

MDS:

Myelodysplastic Syndromes

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Acknowledgments

The case was encountered and the work was completed at Croydon University Hospital. The authors have no proprietary or commercial interest in any of the materials displayed in this case report.

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The authors have no conflict of interest

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Authors and Affiliations

  1. Eye Unit, Croydon University Hospital, 530 London Road, Croydon, CR7 7YE, UK

    Elisabeth De Smit & Eoin O’Sullivan

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  1. Elisabeth De Smit
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  2. Eoin O’Sullivan
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Correspondence to Elisabeth De Smit.

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De Smit, E., O’Sullivan, E. A diagnostic challenge: chronic myelomonocytic leukaemia and recurrent anterior ischaemic optic neuropathy. Int Ophthalmol 33, 415–423 (2013). https://doi.org/10.1007/s10792-012-9675-5

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  • DOI: https://doi.org/10.1007/s10792-012-9675-5

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