4 Citations (Scopus)

Abstract

A 24-year-old male patient with acute lymphoblastic leukaemia (ALL), in complete remission, presented with the symptoms of gradual onset painless diminution of vision in the right eye (OD) of 2-month duration. On examination, best-corrected visual acuity in OD was finger-counting at 1m and near vision was less than N 36. Anterior segment examination was normal, except for the presence of relative afferent pupillary defect in OD. Fundus examination showed optic disc oedema, peripapillary and vitreous haemorrhage, dilated and tortuous veins over the disc and presence of subretinal infiltrates and subretinal fluid around the optic disc. Clinical picture was suggestive of leukaemic infiltration of the optic nerve head. Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts.Vitreous biopsy from OD was suggestive of leukaemic infiltration. After radiotherapy, the leukaemic infiltrates regressed and visual acuity improved to 6/6, N 6 in OD.

Original languageEnglish
Article number217239
JournalBMJ Case Reports
Volume2016
DOIs
Publication statusPublished - 01-01-2016

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Optic Disk
Visual Acuity
Pupil Disorders
Subretinal Fluid
Vitreous Hemorrhage
Recurrence
Papilledema
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Fingers
Cerebrospinal Fluid
Veins
Radiotherapy
Biopsy

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Leukaemic infiltration of the optic nerve head: A rare site of initial relapse",
abstract = "A 24-year-old male patient with acute lymphoblastic leukaemia (ALL), in complete remission, presented with the symptoms of gradual onset painless diminution of vision in the right eye (OD) of 2-month duration. On examination, best-corrected visual acuity in OD was finger-counting at 1m and near vision was less than N 36. Anterior segment examination was normal, except for the presence of relative afferent pupillary defect in OD. Fundus examination showed optic disc oedema, peripapillary and vitreous haemorrhage, dilated and tortuous veins over the disc and presence of subretinal infiltrates and subretinal fluid around the optic disc. Clinical picture was suggestive of leukaemic infiltration of the optic nerve head. Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts.Vitreous biopsy from OD was suggestive of leukaemic infiltration. After radiotherapy, the leukaemic infiltrates regressed and visual acuity improved to 6/6, N 6 in OD.",
author = "Shenoy, {Shailaja Bhat} and Thoiba Karam and Karthik Udupa and Bhavna Nayal",
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Leukaemic infiltration of the optic nerve head : A rare site of initial relapse. / Shenoy, Shailaja Bhat; Karam, Thoiba; Udupa, Karthik; Nayal, Bhavna.

In: BMJ Case Reports, Vol. 2016, 217239, 01.01.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Leukaemic infiltration of the optic nerve head

T2 - A rare site of initial relapse

AU - Shenoy, Shailaja Bhat

AU - Karam, Thoiba

AU - Udupa, Karthik

AU - Nayal, Bhavna

PY - 2016/1/1

Y1 - 2016/1/1

N2 - A 24-year-old male patient with acute lymphoblastic leukaemia (ALL), in complete remission, presented with the symptoms of gradual onset painless diminution of vision in the right eye (OD) of 2-month duration. On examination, best-corrected visual acuity in OD was finger-counting at 1m and near vision was less than N 36. Anterior segment examination was normal, except for the presence of relative afferent pupillary defect in OD. Fundus examination showed optic disc oedema, peripapillary and vitreous haemorrhage, dilated and tortuous veins over the disc and presence of subretinal infiltrates and subretinal fluid around the optic disc. Clinical picture was suggestive of leukaemic infiltration of the optic nerve head. Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts.Vitreous biopsy from OD was suggestive of leukaemic infiltration. After radiotherapy, the leukaemic infiltrates regressed and visual acuity improved to 6/6, N 6 in OD.

AB - A 24-year-old male patient with acute lymphoblastic leukaemia (ALL), in complete remission, presented with the symptoms of gradual onset painless diminution of vision in the right eye (OD) of 2-month duration. On examination, best-corrected visual acuity in OD was finger-counting at 1m and near vision was less than N 36. Anterior segment examination was normal, except for the presence of relative afferent pupillary defect in OD. Fundus examination showed optic disc oedema, peripapillary and vitreous haemorrhage, dilated and tortuous veins over the disc and presence of subretinal infiltrates and subretinal fluid around the optic disc. Clinical picture was suggestive of leukaemic infiltration of the optic nerve head. Cytological analysis of the cerebrospinal fluid did not show any abnormal cells or blasts.Vitreous biopsy from OD was suggestive of leukaemic infiltration. After radiotherapy, the leukaemic infiltrates regressed and visual acuity improved to 6/6, N 6 in OD.

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