Shenoy Shailaja Bhat, Karam Thoiba, Udupa Karthik, Nayal Bhavna
Department of Ophthalmology, Kasthurba Medical College, Manipal University, Manipal, India.
Kasturba Medical College Manipal, Manipal, Karnataka, India.
BMJ Case Rep. 2016 Oct 19;2016:bcr2016217239. doi: 10.1136/bcr-2016-217239.
A 24-year-old male patient with acute lymphoblastic leukaemia (ALL), in complete remission, presented with the symptoms of gradual onset painless diminution of vision in the right eye (OD) of 2-month duration. On examination, best-corrected visual acuity in OD was finger-counting at 1 m and near vision was less than N Anterior segment examination was normal, except for the presence of relative afferent pupillary defect in OD. Fundus examination showed optic disc oedema, peripapillary and vitreous haemorrhage, dilated and tortuous veins over the disc and presence of subretinal infiltrates and subretinal fluid around the optic disc. Clinical picture was suggestive of leukaemic infiltration of the optic nerve head. Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts .Vitreous biopsy from OD was suggestive of leukaemic infiltration. After radiotherapy, the leukaemic infiltrates regressed and visual acuity improved to 6/6, N in OD.
一名24岁急性淋巴细胞白血病（ALL）男性患者，处于完全缓解期，出现右眼（OD）视力逐渐无痛性下降2个月的症状。检查时，OD的最佳矫正视力为1米处指测，近视力小于N。前段检查正常，OD除外有相对性传入瞳孔障碍。眼底检查显示视盘水肿、视盘周围及玻璃体出血、视盘上静脉迂曲扩张以及视盘周围视网膜下浸润和视网膜下液。临床表现提示视神经乳头白血病浸润。脑脊液细胞学分析未显示任何异常细胞或原始细胞。OD的玻璃体活检提示白血病浸润。放疗后，白血病浸润消退，OD的视力提高到6/6，N。
