title: Optic Neuropathy Due to Chronic Lymphocytic Leukemia Proven With Optic Nerve Sheath Biopsy.
abstract: Central nervous system involvement from chronic lymphocytic leukemia (CLL) occurs infrequently, and manifestations include cognitive and cerebellar dysfunction and cranial nerve palsies. We report a 45-year-old man with CLL believed to be in clinical remission, who presented with vision loss and bilateral optic disc edema. His optic neuropathy due to CLL was proven by optic nerve sheath biopsy, and he experienced visual recovery after treatment with ibrutinib and intrathecal methotrexate.
authors.affiliation: Baylor College of Medicine (KK, AGL), Houston, Texas; Department of Ophthalmology (AIM, SJA, MLM, SY, PC-B, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medical College, Houston, Texas; Department of Ophthalmology and Visual Sciences (AGL), The University of Texas Medical Branch, Galveston, Texas; The University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; The University of Iowa Hospitals and Clinics (AGL), Iowa City, Iowa.
authors.forename: Khurrum
authors.initials: K
authors.lastname: Khan
authors.forename: Amina I
authors.initials: AI
authors.lastname: Malik
authors.forename: Sumayya J
authors.initials: SJ
authors.lastname: Almarzouqi
authors.forename: Michael L
authors.initials: ML
authors.lastname: Morgan
authors.forename: Sushma
authors.initials: S
authors.lastname: Yalamanchili
authors.forename: Patricia
authors.initials: P
authors.lastname: Chevez-Barrios
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Lee
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001706:Biopsy; D004359:Drug Therapy, Combination; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009900:Optic Nerve / Q000473:pathology*; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010880:Piperidines; D011720:Pyrazoles / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013129:Spinal Puncture
chemical_list: D000964:Antimetabolites, Antineoplastic; D010880:Piperidines; D011720:Pyrazoles; D011743:Pyrimidines; C551803:ibrutinib; D000225:Adenine; D008727:Methotrexate