Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse

Bilateral Central Retinal Artery Occlusion Associated with Bilateral Lymphoproliferative Infiltrative Optic Neuropathy

“…Though CNS irradiation has been shown to restore visual acuity to baseline or near-baseline in leukemic optic neuropathy [17], [22], this was unfortunately not the case in our patient. As our patient had initially developed CRAO in the left eye, visual prognosis of the left eye was already guarded regardless of CNS irradiation; however, there was hope of halting the progression of right optic nerve infiltration and subsequent CRAO development.…”

“…While there have been case reports of leukemic infiltration of the optic nerve leading to optic disc swelling and vascular occlusion [15], [17], we are aware of only 1 other report in which infiltration was associated with sequential, bilateral CRAO [11]. Lin et al [11] described a 6-year-old male with acute lymphoblastic leukemia who developed CNS relapse while on continuous chemotherapy; despite systemic re-induction and intrathecal chemotherapy with CNS irradiation, he developed CRAO in both eyes and retained NLP vision.…”

Acute promyelocytic leukemic involvement of the optic nerves following mitoxantrone treatment for multiple sclerosis

“…This mechanism may explain the rapid visual deterioration in our patient despite intrathecal chemotherapy. Early administration of focal radiation has been described as an effective means of reducing leukemic cells in the optic canal, thereby allowing adequate penetration of cytotoxic therapy into the perineural space of the optic nerve [25].…”

Ophthalmological Manifestations in Acute Lymphoblastic Leukemia

“…Sometimes the affectation of the optic nerve is asymptomatic and only papilloedema can be found. (Ribera & Ortega, 2003;Lin et al, 2004;Sharma et al, 2004;Mayo et al, 2002) Papilloedema is the most frequent sign of optic nerve involvement. It can be due to direct infiltration of the nerve by leukemic cells, increased intraocular person, or swelling because of retrolaminar leukemic invasion.…”