Richardson-May James, Musa Abdi M, Suresh Priyadarshini, Sniatecki Jan J, Krishnan Radhika
Department of Ophthalmology, University Hospital Southampton, Hampshire, UK.
Neuroophthalmology. 2024 Feb 8;48(5):352-359. doi: 10.1080/01658107.2024.2313579. eCollection 2024.
Leukaemic optic neuropathy is an uncommon cause of visual loss which represents a neuro-oncological emergency with the potential of irreversible blindness if untreated. It can be difficult to diagnose, often presenting with normal neuroradiological and cerebrospinal fluid findings. We present the case of a 26-year-old woman with T-cell acute lymphoblastic leukaemia with optic neuropathy secondary to leukaemic infiltration, who demonstrated features on optical coherence tomography that aided the diagnosis of this condition. This included the presence of numerous, small, hyperreflective opacities erupting from the optic nerve head, which improved following treatment with radiotherapy and chemotherapy, and later recurred when the condition relapsed. This finding may help clinicians differentiate between other causes of optic neuropathy as well as assessing response to treatment and monitoring for recurrence.
白血病性视神经病变是视力丧失的一种罕见原因，它是一种神经肿瘤急症，如果不治疗，有可能导致不可逆的失明。其诊断可能很困难，通常神经影像学和脑脊液检查结果正常。我们报告了一例26岁患有T细胞急性淋巴细胞白血病的女性病例，该患者因白血病浸润继发视神经病变，光学相干断层扫描显示的特征有助于诊断此病。这些特征包括从视神经乳头出现大量小的高反射性混浊，放疗和化疗后有所改善，病情复发时又再次出现。这一发现可能有助于临床医生区分视神经病变的其他原因，以及评估治疗反应和监测复发情况。
