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| LETTER TO THE EDITOR |
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| Year : 2011 | Volume
: 4
| Issue : 1 | Page : 40 |
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Optic nerve infiltration in relapse of acute lymphoblastic leukemia
Mohammad Javed Ali, Santosh G Honavar
Department of Ocular Oncology Services, L. V. Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad - 500 034, India
| Date of Web Publication | 14-Mar-2011 |
Correspondence Address:
Santosh G Honavar
FACS, Ocular Oncology Service, L.V.Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad - 500034
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-620X.77665
How to cite this article:
Ali MJ, Honavar SG. Optic nerve infiltration in relapse of acute lymphoblastic leukemia. Oman J Ophthalmol 2011;4:40 |
Sir,
We read with great interest the article by Bandyopadhyay et al. [1] on unilateral optic nerve infiltration as an initial site of relapse in patients with acute lymphoblastic leukemia (ALL), in remission. The authors have indeed reported a rare and important ophthalmic manifestation. Although periodic ophthalmic examinations are to be conducted in patients with acute leukemia, [2],[3] we do not agree with the authors' recommendation that for early diagnosis of ALL relapse, a periodic ophthalmic examination is warranted, as it is extremely rare to develop optic nerve infiltration, as admitted by the authors themselves, and this conclusion would be premature based on a single case report.
We also do not agree with the attribution of subnormal vision solely to radiation optic neuropathy. It could be a sequel of the disc edema itself. When commenting on computed tomography (CT) scans in such patients, it is imperative to mention the presence or absence of Central Nervous System (CNS) relapse, radiologically. CT and magnetic resonance imaging (MRI) are more helpful in differentiating optic disc edema due to leukemic infiltrates from true papilledema due to central nervous system involvement. [2],[4]
 References | |  |
| 1. | 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. 
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| 2. | Shields JA, Shields CL. Intraocular leukemia. Intraocular tumors - A text and Atlas. In: Shields CL, Shields JA, editors. 2 nd ed. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 530-4.
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| 3. | Kassam F, Gale JS, Sheidow TG. Intraocular leukemia as a primary manifestation of relapsing acute myelogenous leukemia. Can J Ophthalmol 2003;38:613-6.
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| 4. | Wallace RT, Shield JA, Shields CL, Ehya H, Ewing M. Leukemic infiltration of the optic nerve. Arch Ophthalmol 1991;109:1027.
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