Optic Nerve and Retina Infiltration in Lymphoproliferative Diseases Case Series
Accept poster if oral is not possible ?
Yes
Purpose
Infiltration of optic nerve (ON) and retina is a rare/challenging presentation of lymphomas/leukemias.We aim to characterize clinical presentation/management of five such cases at a uveitis referral center
Methods
Retrospective chart review of clinical/laboratorial data, and of multimodal imaging
Results
Case 1:29-year-old(YO) man had acute lymphoblastic leukemia and vision loss in both eyes post-chemotherapy. ON infiltration was treated with steroids/QT. Vision worsened before bone marrow transplantation, progressing to optic nerve/retinal atrophy(ONRA)
Case 2:35 YO woman with pre-B ALL, presented with decreased vision in OS during QT. ON infiltration was succefully treated with intrathecal and repeated intravitreal methotrexate(MTX), subsequently with local recurrences in OU managed with intravitreal MTX
Case 3:13 YO boy with acute myeloid leukemia, experienced sudden vision worsening/strabismus. Imaging revealed a central nervous system lesion, with a treatment plan including radiotherapy(RT) and QT.
Case 4:13 YO boy with T-ALL preparing for BMT had decreased vision in OU, after unsuccesful treatment for presumed intraocular infection. Bilateral ON infiltration was seen, and intravitreal MTX injections initiated, followed by intrathecal/systemic QT, RT, and a sucessful BMT.
Case 5: 62 YO man had ON and extensive retinal infiltration in OD, and was diagnosed with primary vitreoretinal lymphoma after chorioretinal biopsy.He received systemic QT and intravitreal MTX, with resolution of ON/retinal infiltration, but evolving with ONRA
Conclusion
Infiltration by lymphoproliferative diseases in the ON/retina is rare and challenging.Visual prognosis is variable, but with a risk of ONRA, even after successful interventions
Conflict of interest
No
1
Last name
GONZAGA
Initials of first name(s)
JNM
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
2
Last name
MENDONCA
Initials of first name(s)
ALP
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
3
Last name
SANTOS
Initials of first name(s)
HH
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
4
Last name
AZEVEDO
Initials of first name(s)
DOM
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
5
Last name
ALMEIDA
Initials of first name(s)
EF
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
6
Last name
VASCONCELOS-SANTOS
Initials of first name(s)
DV
Department
Hospital São Geraldo - UFMG
City
Belo Horizonte
Country
Brazil
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