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 1 m and near vision was less than N36Anterior 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, N6in OD.
authors: Department of Ophthalmology, Kasthurba Medical College, Manipal University, Manipal, India.
authors: Shailaja Bhat
authors: SB
authors: Shenoy
authors: Kasturba Medical College Manipal, Manipal, Karnataka, India.
authors: Thoiba
authors: T
authors: Karam
authors: Department of Medical Oncology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors: Karthik
authors: K
authors: Udupa
authors: Department of Pathology, Kasturba Medical College, Manipal, Manipal University, Manipal, Karnataka, India.
authors: Bhavna
authors: B
authors: Nayal
mesh_terms: D001766:Blindness / Q000209:etiology*; D006801:Humans; D017254:Leukemic Infiltration / Q000150:complications*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D009898:Optic Disk; D019574:Optic Nerve Neoplasms / Q000150:complications*; D010211:Papilledema / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D014823:Vitreous Hemorrhage / Q000209:etiology; D055815:Young Adult