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Type de présentationOral presentation
TitreLeukemic optic neuropathy as first sign of leukaemia: a case-report
ButMild opthalmic manifestations are not a rarity in leukaemia, with mainly retinal haemorrhages as most common finding. However optic nerve infiltration is quite uncommon and can mimic more prevalent conditions of unilateral optic disc oedema. We present a case of leukemic optic neuropathie (LON) as the initial presentation of acute myeloid leukaemia.
Méthodes/
RésultatsA 68-year-old man presented with a blurry spot in his left eye and mild unilateral optic disc oedema with associated visual field defect. Laboratory testing was performed to determine the cause of the oedema and revealed an abnormal white blood cell count, leading to the diagnosis of acute myeloid leukaemia. While ruling out other causes, the optic disc oedema progressed significantly with peripapillary haemorrhages and cotton wool spots. Ultimatly neurological as well as infectious work-up remained negative. This lead to the diagnosis of LON. As a review of the literature yielded no established protocol beyond high-dose steroids, we switched to our in-house optic neuritis protocol. This consisted of high-dose intravenous steroids with oral tapering afterwards, under cover of leukaemia-directed therapy. Unfortunately, despite adequate therapy and resolution of oedema, visual recovery remained incomplete.
ConclusionLON is a rare but potentially vision-threatening feature of acute leukaemia that should be considered in patients presenting with disc oedema, even in the absence of systemic symptoms. Early laboratory evaluation will aid in recognising an underlying haematological malignancy. Given the rarity of LON and the lack of established treatment protocols, further reports are needed to improve recognition and guide management.
Conflit d'intérêtNon
Auteurs 1
NomSCHEPERS
InitialesE
InstitutZiekenhuis Oost-Limburg en KULeuven
VilleGenk, Leuven
Auteurs 2
NomDeghislage
InitialesC
InstitutZiekenhuis Oost-Limburg
VilleGenk
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