About OJO | Search | Ahead of print | Current Issue | Archives | Author Instructions | Reviewer Guidelines | Online submissionLogin 
Oman Journal of Ophthalmology Oman Journal of Ophthalmology
  Editorial Board | Subscribe | Advertise | Contact
https://www.omanophthalmicsociety.org/ Users Online: 2544  Wide layoutNarrow layoutFull screen layout Home Print this page  Email this page Small font size Default font size Increase font size


 
 Table of Contents    
LETTER TO THE EDITOR
Year : 2011  |  Volume : 4  |  Issue : 2  |  Page : 101-102  

Isolated optic nerve infiltration as a site of relapse of acute lymphoblastic leukemia


1 Department of Ophthalmology, R. G. Kar Medical College and Hospital, Kolkata, India
2 Department of Pediatrics, R. G. Kar Medical College and Hospital, Kolkata, India

Date of Web Publication10-Aug-2011

Correspondence Address:
Sabyasachi Bandyopadhyay
11/11, Ghosal Para Road, Dakshin Para, Barasat, Kolkata - 700 124
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-620X.83668

Rights and Permissions

How to cite this article:
Bandyopadhyay S, Das D, Das G, Gayen S. Isolated optic nerve infiltration as a site of relapse of acute lymphoblastic leukemia. Oman J Ophthalmol 2011;4:101-2

How to cite this URL:
Bandyopadhyay S, Das D, Das G, Gayen S. Isolated optic nerve infiltration as a site of relapse of acute lymphoblastic leukemia. Oman J Ophthalmol [serial online] 2011 [cited 2019 Dec 6];4:101-2. Available from: http://www.ojoonline.org/text.asp?2011/4/2/101/83668

Sir,

We greatly appreciate the opinion by Ali et al. [1] on optic nerve infiltration in relapse of acute lymphoblastic leukemia (ALL) in response to our article on unilateral optic nerve infiltration as an initial site of relapse of ALL in remission.

The initial presentation of relapse of ALL as isolated unilateral optic nerve infiltration though rare has been reported in the literature. [2],[3],[4],[5] After publication of this case report, we found another boy of 10 years in our hospital with similar presentation (unpublished observation). The rarity of this entity may be due to underreporting of the cases.

On relapse, the visual acuity of the right eye was 20/200. We agree with Ali et al. [1] that this reduced vision was due to leukemic optic nerve infiltration presenting as unilateral optic disc edema. Following chemotherapy and radiotherapy, there was reduction of optic disc edema. The visual acuity improved only to 20/80, which was less than expected following reduced optic disc edema. The further non-improvement could be attributed to a combination of sequel of optic disc edema and radiation optic neuropathy.

The computed tomography scan of brain and orbit showed only right-sided optic nerve infiltration. There was no other sign of central nervous system involvement. The thickened right optic nerve in the computed tomography scan depicts optic nerve infiltration as the cause of optic disc edema excluding true papilledema due to central nervous system involvement. Furthermore, the optic disc edema was unilateral as opposed to true papilledema which is bilateral.

To conclude, the relapse of ALL as unilateral optic nerve infiltration may occur in the presence of normal complete blood count and bone marrow examination. Hence, regular ophthalmic check-up is advocated to facilitate early detection of relapse and initiation of combined chemotherapy and radiotherapy.

 
   References Top

1.Ali MJ, Honavar SG. Optic nerve infiltration in relapse of acute lymphoblastic leukemia. Oman J Ophthalmol 2011;4:40.   Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Lin YC, Wang AG, Yen MY, Hsu WM. Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse. Eye (Lond) 2004;18:546-50.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Nikaido H, Mishima H, Ono H, Choshi K, Dohy H. Leukemic involvement of the optic nerve. Am J Ophthalmol 1988;105:294-8.  Back to cited text no. 3
[PUBMED]    
4.Lin HF, Dai MS, Kao WY, Chao TY. Unilateral optic nerve leukemic infiltration with sudden vision loss heralding a systemic relapse of acute lymphoblastic leukemia. J Med Sci 2005;25:97-100.  Back to cited text no. 4
    
5.Bandyopadhyay S, Das D, Das G, Gayen S. Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission. Oman J Ophthalmol 2010;3:153-4.  Back to cited text no. 5
[PUBMED]  Medknow Journal  




 

Top
   
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed1487    
    Printed75    
    Emailed0    
    PDF Downloaded230    
    Comments [Add]    

Recommend this journal