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TitelLeukaemic infiltration of the optic nerve
DoelTo report the importance of an ophthalmological consult in a patient with headache and blurred vision, who had a previous history of acute myelocytic leukaemia (AML) and was in succesfull remission.
MethodesA case report
ResultatenA 39-year old woman suffered from headache and blurred vision. Fundoscopy showed bilateral prominent papil edema. Additional ophthalmological examinations were all abnormal, but contrast MRI of the brain was normal. We insisted on doing a lumbar puncture to evaluate intracranial pressure and collect CSF. This lumbar puncture showed a very high opening pressure and cytology revealed massive presence of leucocytosis from leukaemic blasts.
The diagnosis of meningeal leukaemia was made and an urgent treatment of intrathecal chemotherapy and pancraniel radiotherapy could be started till disappearance of the malignant cells.
ConclusieIn a patient with headache and blurred vision with a history of AML, an urgent ophthalmological consult has to be made, because optic disc swelling could be the only sign of relapse with leukaemic infiltration of the optic nerve. Further examinations and immediate therapy are required to preserve vision.
Auteur 1
NaamAERTS
InitialenL
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
Auteur 2
NaamDe Veuster
InitialenI
InstituutAntwerp University Hospital, Department of Ophthalmology
StadEdegem
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