Optic neuropathy in chronic lymphocytic leukemia
J. N. Currie, S. Lessell, I. M. Lessell, J. S. Weiss, D. M. Albert and E. M. Benson
Neuroophthalmology Section, National Eye Institute, Bethesda, Md.
Ophthalmic and neurologic involvement in chronic lymphocytic leukemia is
uncommon, and if it does occur, it is usually only late in the course of
the disease. We report three cases in which progressive visual loss from
optic nerve infiltration was an early clinical manifestation of chronic
lymphocytic leukemia. Progressive optic atrophy with loss of acuity and
visual field occurred in all cases, preceded in one patient by transient
visual obscurations and disc edema. Surface marker studies of cerebrospinal
fluid lymphocytes were useful in differentiating leukemic optic nerve
infiltration from other causes of optic nerve damage. Optic nerve
irradiation gave considerable clinical improvement in all three cases.
