Dr R P Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Dr R P Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2021 Jun 28;14(6):e243689. doi: 10.1136/bcr-2021-243689.
Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer, with 70%-80% of cases curable with modern chemotherapy. However, 20% of the cases suffer from disease relapse with bone marrow being the most common site. Isolated ocular involvement as the first sign of relapse is extremely rare, occurring in less than 2.2% of cases. The presentation of optic nerve involvement in leukaemia represents a visual emergency and a sign of isolated central nervous system relapse even in the absence of abnormal cerebrospinal fluid cytology. This case highlights the importance of routine ophthalmic screening in ALL even during maintenance phase and prompt initiation of treatment in cases with isolated optic nerve involvement.
急性淋巴细胞白血病（ALL）是最常见的儿童癌症，70%-80%的病例可通过现代化疗治愈。然而，20%的病例会出现疾病复发，骨髓是最常见的复发部位。孤立性眼部受累作为复发的第一个迹象极其罕见，不到 2.2%的病例会出现这种情况。白血病视神经受累的表现是一种视觉急症，也是孤立性中枢神经系统复发的迹象，即使脑脊液细胞学检查正常也是如此。本病例强调了即使在维持阶段，ALL 患者也需要进行常规眼科筛查，以及在出现孤立性视神经受累时及时开始治疗的重要性。
