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Isolated optic nerve relapse in T-cell acute lymphoblastic leukaemia
  1. Isana Nakajima1,
  2. Yuko Shirouchi2,
  3. Yuka Morita2,
  4. Hideki Tsuji1
  1. 1Department of Ophthalmology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
  2. 2Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
  1. Correspondence to Dr Isana Nakajima; jm-i-nakajima{at}kochi-u.ac.jp

https://doi.org/10.1136/pn-2024-004375

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    A woman in her 60s developed decreased vision in her right eye. She had a history of a T-cell acute lymphoblastic leukaemia (t-ALL)/lymphoblastic lymphoma that had presented as a mediastinal mass. Following multiagent induction therapy, she was in complete haematological remission. At the time of the visual symptom, she was receiving consolidation therapy including high-dose methotrexate, high-dose cytarabine and intrathecal injections.

    On examination, her best corrected visual acuity was 0.8 in the right eye and 1.0 in the left eye. Ophthalmoscopy showed right optic disc swelling with haemorrhage, but with no retinal haemorrhage or Roth spots (figure 1A,B, top). Optical coherence tomography identified serous retinal detachment in the right eye; the left eye was …

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    Footnotes

    • Contributors IN: literature search, image selection, drafting and critical revision of the manuscript. IN is the guarantor. YS, YM: critical revision of the manuscript. HT: literature search, image selection and critical revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed by Ed Margolin, Toronto, Canada.