scholarly journals Unilateral Blurred Vision as the Sole Presenting Symptom of Chronic Lymphocytic Leukemia

2020 ◽  
Author(s):  
Rajesh K. Sharma ◽  
Kevin Mays
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
White Male ◽  
Lymphocytic Leukemia ◽  
Fiber Layer ◽  
Blurred Vision ◽  
Optic Disc Swelling ◽  
Blurry Vision ◽  
Eye Examination

Purpose: To describe a case of infiltrative optic neuropathy caused by chronic lymphocytic leukemia. Case Report: A 41-year-old white male presented with painless, blurry vision in the left eye. Examination revealed unilateral optic nerve swelling confirmed by optical coherence tomography (OCT). Initial workup revealed mild leukocytosis, eventually diagnosed as chronic lymphocytic leukemia (CLL). No other cause of optic neuropathy was identified despite extensive investigation. The patient developed rapidly progressive retinal ganglion cell nerve fiber layer (NFL) atrophy and relative afferent pupillary defect (RAPD) of the left eye despite steroid treatment but stabilized after four cycles of CLLtargeted chemotherapy. Although infiltrative optic neuropathy is well-known in leukemia, presentation with only subtle vision loss is rare. Vision loss usually presents late in leukemic infiltrative optic neuropathy and therefore must be considered in patients with optic disc swelling and leukocytosis. Conclusion: When treating CLL, progressive visual decline with coexistent optic neuropathy may warrant chemotherapy.

scholarly journals Tacrolimus-induced bilateral optic neuropathy: A case report

2021 ◽  
pp. 4-4
Author(s):  
Lepsa Zoric ◽  
Aleksandra Ilic ◽  
Emina Colak ◽  
Milos Mirkovic ◽  
Jelica Pantelic ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
White Male ◽  
Immunosuppressive Drug ◽  
Organ Rejection ◽  
Toxic Optic Neuropathy ◽  
Tacrolimus Therapy ◽  
Male Patients

Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosupressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old white male patients who had received tacrolimus therapy for nine years, after kidney transplantation, developed a subacute, painless vision loss on both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. His therapy was converted to cyclosporine, by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on nervous system, optic neuropathy can causes great and permanent functional impairment.

scholarly journals Optic neuropathy due to chronic lymphocytic leukemia: The first manifestation of the disease

2020 ◽  
Vol 18 ◽  
pp. 100603
Author(s):  
Diogo Maleita ◽  
Rita Serras Pereira ◽  
Diogo Hipolito-Fernandes ◽  
Nuno Moura-Coelho ◽  
João Paulo Cunha ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Optic Neuropathy ◽  
Lymphocytic Leukemia

scholarly journals Chronic lymphocytic leukemia (CLL) terminating in multiple myeloma: report of two cases

Blood ◽  
1978 ◽  
Vol 52 (3) ◽  
pp. 532-536 ◽  
Author(s):  
RH Kough ◽  
AZ Makary
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
Plasma Cells ◽  
Medical Center ◽  
White Male ◽  
Lymphocytic Leukemia ◽  
Light Chains ◽  
White Female ◽  
Pathologic Fractures

Abstract Two cases of multiple myeloma (MM) developed late in the course of chronic lymphocytic leukemia (CLL). An 81-yr-old white female developed, after 6 yr of CLL, IgAk MM with sheets of plasma cells abutting sheets of lymphocytes in the bone marrow, multiple pathologic fractures, and 0.26 g/24 free k light chains in the urine. A 74-yr-old white male developed, after 16 yr of CLL, k light chain MM with 20% plasma cells in the bone marrow, multiple panthologic fractures, and 3.7 g/24 hr free k light chains in the urine. In both cases the CLL had responded well to intermittent low-dose chlorambucil therapy, but the MM failed to respond to cyclic melphalanprednisone therapy. A review of 105 cases of CLL seen at the Geisinger Medical Center failed to turn up any other cases of MM developing during the course of CLL. The suggestion that there is an increased prevalence of MM in CLL is an attractive one because both diseases are B cell neoplasms and because of the increased frequency of asymptomatic monoclonal gammopathies in CLL found by others.

scholarly journals Traumatic Optic Neuropathy and Monocular Blindness following Transnasal Penetrating Optic Canal Injury by a Wooden Foreign Body

2018 ◽  
Vol 9 (2) ◽  
pp. 341-347
Author(s):  
Reem Younis ◽  
Eran Berkowitz ◽  
Roni Shreter ◽  
Anat Kesler ◽  
Itzhak Braverman
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Traumatic Optic Neuropathy ◽  
Blurred Vision ◽  
Unaffected Side ◽  
Small Branch ◽  
Wooden Foreign Body ◽  
The Right

Purpose: To report a case of right eye blindness due to a penetrating injury in the contralateral nostril. Methods: This is a case report of a 67-year-old patient who presented to the emergency room complaining of transient blurred vision in his right eye after falling on a small branch with no apparent injury besides minor lacerations. The following day, the patient experienced blindness in the right eye. Physical examination revealed small lacerations on his left forehead and optic neuropathy on the right side with no other obvious discerning physical or imaging abnormalities. Results: After elevated suspicion and reassessment of the neuroimaging findings, a radiolucent track was observed in the nasal cavity, continuing up from the left nostril to the right optic nerve. Transnasal endoscopic surgery was performed and a long wooden branch was removed from the nasal cavity. Conclusion: A nasally penetrating wooden foreign body can cause traumatic optic neuropathy and vision loss on the unaffected side and can be very difficult to locate and image without any clear external evidence as to its presence. This case highlights the importance of maintaining a high level of suspicion in these types of cases.

scholarly journals Chronic lymphocytic leukemia (CLL) terminating in multiple myeloma: report of two cases

Blood ◽  
1978 ◽  
Vol 52 (3) ◽  
pp. 532-536
Author(s):  
RH Kough ◽  
AZ Makary
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
Plasma Cells ◽  
Medical Center ◽  
White Male ◽  
Lymphocytic Leukemia ◽  
Light Chains ◽  
White Female ◽  
Pathologic Fractures

Two cases of multiple myeloma (MM) developed late in the course of chronic lymphocytic leukemia (CLL). An 81-yr-old white female developed, after 6 yr of CLL, IgAk MM with sheets of plasma cells abutting sheets of lymphocytes in the bone marrow, multiple pathologic fractures, and 0.26 g/24 free k light chains in the urine. A 74-yr-old white male developed, after 16 yr of CLL, k light chain MM with 20% plasma cells in the bone marrow, multiple panthologic fractures, and 3.7 g/24 hr free k light chains in the urine. In both cases the CLL had responded well to intermittent low-dose chlorambucil therapy, but the MM failed to respond to cyclic melphalanprednisone therapy. A review of 105 cases of CLL seen at the Geisinger Medical Center failed to turn up any other cases of MM developing during the course of CLL. The suggestion that there is an increased prevalence of MM in CLL is an attractive one because both diseases are B cell neoplasms and because of the increased frequency of asymptomatic monoclonal gammopathies in CLL found by others.

scholarly journals A surgical cause of pseudopapilledema

2019 ◽  
Vol 1 (3) ◽  
pp. 222-229
Author(s):  
Chua Shee Wen ◽  
Teo Shee Kiang ◽  
Malisa Ami ◽  
Mushawiahti Mustapha ◽  
Tang Seng Fai
Keyword(s):  
Macular Hole ◽  
Optic Disc ◽  
Anterior Segment ◽  
Lamellar Macular Hole ◽  
Blurred Vision ◽  
Insidious Onset ◽  
Vitreoretinal Traction ◽  
Optic Disc Swelling ◽  
Eye Examination ◽  
Retinal Pathologies

We report a case of vitreopapillary traction mimicking optic disc swelling in a 73-year-old female with pseudophakia in the left eye and satisfactory postoperative vision of 6/6 and N5 two years prior. She presented with insidious onset of blurred vision in her left eye for two months. She was referred to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for further investigations of apparent optic disc swelling in the left eye by a general ophthalmologist. Her left eye vision was 6/18, pinhole 6/12, with near vision at N6. There was no relative afferent pupillary defect and anterior segment examination was normal. Examination of the posterior segment revealed a pink optic disc with blurred and elevated margins without hyperaemia. Vessels of the optic nerve head appeared normal and a lamellar macular hole was present with dull foveal reflex clinically. Right eye examination was normal. Optical coherence tomography (OCT) of the left eye using the raster line scan showed vitreopapillary traction surrounding the optic disc and vitreomacular traction (VMT) with lamellar macular hole. The patient was counselled for surgical release of VMT, however, she opted for conservative management. Peripapillary vitreoretinal traction is a rare cause of pseudo-optic disc swelling. Thorough fundus examination with the help of OCT is crucial in making a prompt diagnosis, preventing unnecessary investigations, and evaluating other retinal pathologies which may benefit from treatment.  

Optic Neuropathy Due to Chronic Lymphocytic Leukemia Proven With Optic Nerve Sheath Biopsy

2016 ◽  
Vol 36 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Khurrum Khan ◽  
Amina I. Malik ◽  
Sumayya J. Almarzouqi ◽  
Michael L. Morgan ◽  
Sushma Yalamanchili ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Chronic Lymphocytic Leukemia ◽  
Optic Neuropathy ◽  
Lymphocytic Leukemia ◽  
Optic Nerve Sheath ◽  
Nerve Sheath

Optic Neuropathy in Chronic Lymphocytic Leukemia

1988 ◽  
Vol 106 (5) ◽  
pp. 654-660 ◽  
Author(s):  
J. N. Currie ◽  
S. Lessell ◽  
I. M. Lessell ◽  
J. S. Weiss ◽  
D. M. Albert ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Optic Neuropathy ◽  
Lymphocytic Leukemia

scholarly journals Stage IV Small Lymphocytic Lymphoma Presenting with Unilateral Vision Loss

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Christopher Le ◽  
Adam Jacob ◽  
Devarajan Iyengar ◽  
John Dedousis ◽  
Antonios Tsompanidis
Keyword(s):  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
Lymph Nodes ◽  
B Cell ◽  
Vision Loss ◽  
Stage Iv ◽  
Small Cell ◽  
Lymphocytic Leukemia ◽  
Neurologic Manifestations ◽  
Small Lymphocytic Lymphoma

Small lymphocytic lymphoma (SLL) is a manifestation of chronic lymphocytic leukemia (CLL) in which malignant B-cell lymphocytes accumulate in the lymph nodes or bone marrow. In this report, we describe the medical course of a patient diagnosed with stage IV small cell lymphocytic lymphoma, who presented to the emergency room with acute neurologic manifestations of SLL.

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