Pritzker School of Medicine (VL), University of Chicago, Chicago, Illinois; and Department of Ophthalmology and Visual Science (AVF, HAS), University of Chicago, Chicago, Illinois.
J Neuroophthalmol. 2021 Dec 1;41(4):e796-e802. doi: 10.1097/WNO.0000000000001365.
Optic neuropathy in the context of leukemia and lymphoma raises concern for central nervous system involvement or relapse and warrants prompt evaluation and treatment. To date, a gold standard for the diagnosis and management of leukemic optic neuropathy has yet to be established.
Case series and review of the literature. Two illustrative cases were selected to discuss their treatment course and outcome.
We report 7 cases of patients with leukemia or lymphoma presenting with optic nerve infiltration. All patients received steroid therapy for presumed infiltrative optic neuropathy, and 4 patients underwent radiation therapy. Along with systemic chemotherapy, all patients received intrathecal chemotherapy except one. Three patients received chimeric antigen receptor T-cell therapy.
Leukemic and lymphomatous optic neuropathy is difficult to diagnose and treat, and there is no gold standard for diagnosis or treatment in the current literature. We help clarify how this disease should be approached in a multidisciplinary fashion and on an individual basis to correctly diagnose and treat the vision loss, while considering the patient's long-term prognosis based on their systemic disease.
白血病和淋巴瘤相关的视神经病变引起了对中枢神经系统受累或复发的关注，需要及时进行评估和治疗。迄今为止，尚未建立白血病性视神经病变的诊断和管理的金标准。
病例系列和文献复习。选择了两个说明性病例来讨论其治疗过程和结果。
我们报告了 7 例白血病或淋巴瘤患者出现视神经浸润。所有患者均接受类固醇治疗，推测为浸润性视神经病变，4 例患者接受了放疗。除了 1 例患者之外，所有患者均接受了鞘内化疗，同时接受全身化疗。3 例患者接受了嵌合抗原受体 T 细胞治疗。
白血病和淋巴瘤性视神经病变的诊断和治疗较为困难，目前文献中尚无诊断或治疗的金标准。我们帮助阐明了如何以多学科的方式和个体化的方式来正确诊断和治疗视力丧失，同时根据患者的全身疾病来考虑其长期预后。
