Sustained visual recovery after treatment with intrathecal methotrexate in a case of optic neuropathy caused by chronic lymphocytic leukemia.
A 68-year-old woman with chronic lymphocytic leukemia (CLL) had acute optic neuropathy associated with cerebrospinal fluid evidence of meningeal spread of CLL. There was no evidence of a hematologic relapse. After undergoing four weekly doses of intrathecal methotrexate, vision improved dramatically and spinal fluid became normal. Four years later, she has near normal vision in the affected eye and remains in hematologic remission. This is the first reported case of successful treatment of optic neuropathy in CLL with intrathecal methotrexate alone.
Mowatt
Lizette
L
Sandwell and West Birmingham NHS Trust, Birmingham and Midland Eye Center, Birmingham, England. lillenea@aol.com
Matthews
Tim
T
Anderson
Ioanne
I
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000503:physiopathology; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D019574:Optic Nerve Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D020127:Recovery of Function; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate