Leukemic optic nerve infiltration as the first symptom of neuroleukemia

Extramedullary leukemic foci in acute leukemia attract special attention. They reflect the diversity of clinical manifestations of the disease, affect the severity of the patient’s condition and may influence the choice of treatment strategy. Purpose: to present a rare clinical case of leukemic opti...

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Main Authors: E. E. Grishina, A. A. Ryabtseva, O. M. Andryukhina, A. O. Mamontov
Format: Article
Language:Russian
Published: Real Time Ltd 2018-10-01
Series:Российский офтальмологический журнал
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Online Access:https://roj.igb.ru/jour/article/view/61
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author E. E. Grishina
A. A. Ryabtseva
O. M. Andryukhina
A. O. Mamontov
author_facet E. E. Grishina
A. A. Ryabtseva
O. M. Andryukhina
A. O. Mamontov
author_sort E. E. Grishina
collection DOAJ
description Extramedullary leukemic foci in acute leukemia attract special attention. They reflect the diversity of clinical manifestations of the disease, affect the severity of the patient’s condition and may influence the choice of treatment strategy. Purpose: to present a rare clinical case of leukemic optical neuropathy in a patient with acute lymphoblast leukemia. Results. Decreased visual acuity of both eyes related to the involvement of the optic nerve was one of the main complaints of the female patient during the onset of the diseases. A loose greyish tumor with blurred contours was identified on the optic nerve disc, with a large number of hemorrhages in various layers of the peripapillary retina. During ophthalmoscopy, the central vessels in the optic disc funnel could not be distinctly differentiated. Brain and orbit MRI showed intraocular masses in the area of the projection of the optic nerve disc and a lesion in the left frontal lobe. There were no signs of high intracranial pressure. After the first chemotherapy course for acute leukemia, visual acuity of both eyes increased, along with a substantial regression of tumor infiltration of the optic disc, which made it possible to visualize the border of the optic disc and the central retinal vessels. Follow-up images showed a full regression of the mass in both eyeballs. The left frontal lesion, whose origin was unclear, remained unchanged. Conclusion. An isolated lesion of the optic nerve could be a potential first sign of neuroleukemia, so it should be on the list for differential diagnosis of optic nerve disorders. First of all, leukemic optic neuropathy should be differentiated from optic nerve edema. Early diagnosis of neuroleukemia and adequate anti-tumor treatment allow for significant improvement of visual acuity and hence, for better quality of life of patients with leukemia // Russian Ophthalmological Journal, 2016; 4: 64-8. doi: 10.21516/2072-0076-2016-9-4-64-68. .
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spelling doaj-art-fb4bfaa43aae45129cfdc8f33deb24a62025-08-20T03:59:21ZrusReal Time LtdРоссийский офтальмологический журнал2072-00762587-57602018-10-0194646810.21516/2072-0076-2016-9-4-64-6861Leukemic optic nerve infiltration as the first symptom of neuroleukemiaE. E. Grishina0A. A. Ryabtseva1O. M. Andryukhina2A. O. Mamontov3M.F. Vladimirsky Moscow Region Research Clinical InstituteM.F. Vladimirsky Moscow Region Research Clinical InstituteM.F. Vladimirsky Moscow Region Research Clinical InstituteM.F. Vladimirsky Moscow Region Research Clinical InstituteExtramedullary leukemic foci in acute leukemia attract special attention. They reflect the diversity of clinical manifestations of the disease, affect the severity of the patient’s condition and may influence the choice of treatment strategy. Purpose: to present a rare clinical case of leukemic optical neuropathy in a patient with acute lymphoblast leukemia. Results. Decreased visual acuity of both eyes related to the involvement of the optic nerve was one of the main complaints of the female patient during the onset of the diseases. A loose greyish tumor with blurred contours was identified on the optic nerve disc, with a large number of hemorrhages in various layers of the peripapillary retina. During ophthalmoscopy, the central vessels in the optic disc funnel could not be distinctly differentiated. Brain and orbit MRI showed intraocular masses in the area of the projection of the optic nerve disc and a lesion in the left frontal lobe. There were no signs of high intracranial pressure. After the first chemotherapy course for acute leukemia, visual acuity of both eyes increased, along with a substantial regression of tumor infiltration of the optic disc, which made it possible to visualize the border of the optic disc and the central retinal vessels. Follow-up images showed a full regression of the mass in both eyeballs. The left frontal lesion, whose origin was unclear, remained unchanged. Conclusion. An isolated lesion of the optic nerve could be a potential first sign of neuroleukemia, so it should be on the list for differential diagnosis of optic nerve disorders. First of all, leukemic optic neuropathy should be differentiated from optic nerve edema. Early diagnosis of neuroleukemia and adequate anti-tumor treatment allow for significant improvement of visual acuity and hence, for better quality of life of patients with leukemia // Russian Ophthalmological Journal, 2016; 4: 64-8. doi: 10.21516/2072-0076-2016-9-4-64-68. .https://roj.igb.ru/jour/article/view/61острый лейкознейролейкемиялейкозная инфильтрация зрительного нервалейкозная оптическая нейропатияacute leukemianeuroleukemialeukemic infiltration of the optic nerveleukemic optical neuropathy
spellingShingle E. E. Grishina
A. A. Ryabtseva
O. M. Andryukhina
A. O. Mamontov
Leukemic optic nerve infiltration as the first symptom of neuroleukemia
Российский офтальмологический журнал
острый лейкоз
нейролейкемия
лейкозная инфильтрация зрительного нерва
лейкозная оптическая нейропатия
acute leukemia
neuroleukemia
leukemic infiltration of the optic nerve
leukemic optical neuropathy
title Leukemic optic nerve infiltration as the first symptom of neuroleukemia
title_full Leukemic optic nerve infiltration as the first symptom of neuroleukemia
title_fullStr Leukemic optic nerve infiltration as the first symptom of neuroleukemia
title_full_unstemmed Leukemic optic nerve infiltration as the first symptom of neuroleukemia
title_short Leukemic optic nerve infiltration as the first symptom of neuroleukemia
title_sort leukemic optic nerve infiltration as the first symptom of neuroleukemia
topic острый лейкоз
нейролейкемия
лейкозная инфильтрация зрительного нерва
лейкозная оптическая нейропатия
acute leukemia
neuroleukemia
leukemic infiltration of the optic nerve
leukemic optical neuropathy
url https://roj.igb.ru/jour/article/view/61
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AT aaryabtseva leukemicopticnerveinfiltrationasthefirstsymptomofneuroleukemia
AT omandryukhina leukemicopticnerveinfiltrationasthefirstsymptomofneuroleukemia
AT aomamontov leukemicopticnerveinfiltrationasthefirstsymptomofneuroleukemia