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Case Reports
. 2022 Mar 21;46(5):322-326.
doi: 10.1080/01658107.2022.2041047. eCollection 2022.

Radiological Features of Bilateral Sequential Leukaemic Optic Nerve Infiltration: A Case Report

Jessica Y Tong  1 , Anna Galanopoulos  2 , Sandy Patel  3 , Dinesh Selva  2
Affiliations
Case Reports

Radiological Features of Bilateral Sequential Leukaemic Optic Nerve Infiltration: A Case Report

Jessica Y Tong et al. Neuroophthalmology. .

Abstract

Leukaemic infiltration of the optic nerve is an oncologic emergency that can lead to a significant risk of irreversible vision loss and has an overall poor systemic prognosis. We present the case of a 77-year-old man in previous systemic remission from acute myeloid leukaemia (AML) who developed bilateral sequential leukaemic optic nerve involvement with eventual complete vision loss. A review of the clinical and radiological characteristics of optic nerve infiltration in AML is provided. Profound vision loss to the order of 20/200 or worse is common. Magnetic resonance imaging features include optic nerve thickening, enhancement of the nerve sheath, T2 hyperintensity and restricted diffusion. Urgent orbital radiotherapy is indicated prior to the onset of irreversible optic nerve damage.

Keywords: Leukaemia; MRI; optic nerve infiltration.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Magnetic resonance imaging of the brain and orbit with gadolinium. Arrows demonstrate the abnormalities. (a) T2 fat-suppressed coronal image demonstrating abnormally hyperintense signal of the left optic nerve substance. (b) T1 fat-suppressed sagittal image with tram-track enhancement of the entire left optic nerve sheath. (c) Diffusion-weighted imaging map demonstrating abnormal restricted diffusion of the left optic nerve, with corresponding low signal on the apparent diffusion coefficient map (d).
See this image and copyright information in PMC

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