Department of Ophthalmology and Optometry, Johannes Kepler University, 4020, Linz, Austria.
BMC Ophthalmol. 2022 Apr 27;22(1):195. doi: 10.1186/s12886-022-02421-y.
We describe a case of an atypical presentation of leukemic optic nerve infiltration.
A patient with acute lymphoblastic leukemia (ALL) in remission suffered from sudden right eye vision loss. At the time of presentation, the affected eye presented with an afferent pupillary defect, while the fundus examination was normal. A complete work up of the patient revealed no signs of ALL relapse, but MR imaging of the optic nerve showed contrast agent uptake consistent with optic nerve infiltration. The patient developed a fulminant ALL relapse and died shortly after. Histology of the optic nerve showed a leukemic infiltration with CD10 positive cells.
This is the first report of an ALL relapse in the optic nerve without intraocular signs. Patients' medical history should therefore be taken into consideration in patients with unclear vision loss.
我们描述了一例非典型的白血病视神经浸润表现。
一位处于缓解期的急性淋巴细胞白血病（ALL）患者突发右眼视力丧失。就诊时，患眼出现传入性瞳孔障碍，眼底检查正常。对患者进行全面检查并未发现 ALL 复发的迹象，但视神经磁共振成像显示对比剂摄取符合视神经浸润。患者随后迅速发生 ALL 复发，并在短时间内死亡。视神经组织学显示有 CD10 阳性细胞的白血病浸润。
这是首例无眼内表现的视神经 ALL 复发的报告。因此，对于原因不明的视力丧失患者，应考虑其病史。
