Leukemic Infiltrative Optic Neuropathy
A 28-year-old male presents with complaints of progressive blurring OD for 4 days. This patient has a past medical history of acute lymphocytic leukemia. Ophthalmic consultation revealed severe loss of vision with light perception in the right eye and 6/5 with glasses correction in the left eye. Intraocular pressure and anterior segment examination were both normal on exam. Ophthalmoscopic examination showed optic disc edema in the right eye (Fig. 3.1). The visual field was almost completely obscured in the right eye (Fig. 3.2). MRI showed perineural infiltration of the right optic nerve (Fig. 3.3). Under the impression of leukemic infiltrative optic neuropathy, the patient received chemotherapy with 6MP, MTX, Ara-C, and mitoxantrone. Right optic disc pallor was observed 1 month later, with a resultant loss of vision.
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