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K. Sharma R, Mays K. Unilateral Blurred Vision as the Sole Presenting Symptom of Chronic Lymphocytic Leukemia. JOVR [Internet]. 2020Feb.3 [cited 2024Apr.18];15(1):109–112. Available from: https://knepublishing.com/index.php/JOVR/article/view/5958

https://doi.org/10.18502/jovr.v15i1.5958

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authors

  • Rajesh K. Sharma

    Rajesh K. Sharma

    Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA; Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA
  • Kevin Mays

    Kevin Mays

    Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA

Published Date

  • Feb 3, 2020
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

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

Journal of Ophthalmic and Vision Research (JOVR) / January–March 2020, Volume 15, Issue 1 / Pages 109–112

Abstract

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.

Keywords:

Chronic Lymphocytic Leukemia, Optic Neuropathy

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