title: Relapsed Acute Lymphoblastic Leukemia Presenting as Optic Neuritis.
abstract: Leukemic infiltration of the optic nerve is rare [1]. [Camera, A., Piccirillo, G., Tranfa, F., Rosa, N., Frigeri, F., Martinelli, V., Rotoloi, B. (1993) "Optic nerve involvement in acute lymphoblastic leukemia", Leuk. Lymph. 11, 153-155]. Radiotherapy should be given urgently to all patients with optic nerve infiltrate to restore their vision [2]. [Rosenthal, A. (1983) "Ocular manifestation of leukemia", Ophthalmology 90, 899-905]. We report a case of a unilateral optic nerve relapse 7 months after diagnosis of acute lymphoblastic leukemia (ALL) in a 17-year-old boy who had been off treatment for 6 weeks. The ocular symptoms was initially diagnosed as primary optic neuritis and treated with corticosteroids resulting in temporary clinical recovery. Radiation therapy for ocular leukemia that was commenced 2 months after the onset of symptoms failed to reverse the visual loss. The lack of a reliable and effective tool to diagnose ocular leukemia at an early stage has resulted in significant treatment delay and poor visual outcome.
authors.affiliation: a Division of Hematology and Stem Cell Transplantation, Department of Medicine , Universiti Kebangsaan Malaysia (UKM) , Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur , Malaysia.
authors.forename: S A
authors.initials: SA
authors.lastname: Fadilah
authors.affiliation: b Division of Neurology, Department of Medicine , Universiti Kebangsaan Malaysia (UKM) , Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur , Malaysia.
authors.forename: A A
authors.initials: AA
authors.lastname: Raymond
authors.affiliation: a Division of Hematology and Stem Cell Transplantation, Department of Medicine , Universiti Kebangsaan Malaysia (UKM) , Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur , Malaysia.
authors.forename: S K
authors.initials: SK
authors.lastname: Cheong
authors.affiliation: c Department of Ophthalmology, Faculty of Medicine , Universiti Kebangsaan Malaysia (UKM) , Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur , Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Faridah
keywords: Acute lymphoblastic leukemia; Acute visual loss; Fine-needle aspiration (FNA); Ocular leukemia; Optic neuritis