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Presentation type	Oral presentation
Title	Leukemic optic neuropathy as first sign of leukaemia: a case-report

Purpose	Mild 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.
Methods	/
Results	A 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.
Conclusion	LON 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.
Conflict of interest	No

Authors 1

Last name	SCHEPERS
Initials	E
Department	Ziekenhuis Oost-Limburg en KULeuven
City	Genk, Leuven

Authors 2

Last name	Deghislage
Initials	C
Department	Ziekenhuis Oost-Limburg
City	Genk