급성골수구성백혈병에서 재발의 첫 임상증상으로 나타난 시신경유두 침범의 1예

• 영문명: Leukemic Infiltration of the Optic Nerve Head as the Initial Manifestation of Leukemic Relapse
• 발행기관: 대한안과학회
• 저자명: 박새미 박성규 박태관,Saemi Park, MD, Seong-Kyu Park, MD, PhD, Tae Kwann Park, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume52,number2, 250~254쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2011.02.15

영문 초록

Purpose: To present a case of leukemic infiltration of the optic nerve head as the initial manifestation of leukemic relapse. Case summary: A 65-year-old woman was diagnosed with acute myeloid leukemia. Complete remission was achieved after 4 complete courses of chemotherapy. She complained of a sudden decrease in visual acuity in her left eye. Fundus examination showed severe optic disc edema with peripapillary hemorrhage and serous retinal detachment. Visual acuity and fundus continued to aggravate and high-dose intravenous steroid therapy was instituted. Visual acuity and fundus deteriorated more after treatment. Brain magnetic resonance imaging and CSF study were normal but intrathecal chemotherapy and focal irradiation were performed on account of the suspected CNS involvement of leukemia. Morphologic improvement in the retinal structure was achieved, however, optic atrophy remained and her vision did not recover. Conclusions: The present case shows the involvement of the optic nerve head as the initial isolated manifestation for the relapse in a patient with complete remission. CNS involvement is rare in acute myeloid leukemia and in particular, the optic nerve is rarely reported as the initial isolated presentation for the relapse. Moreover, the disease progression relatively aggravated after treatment. In the atypical aspects of leukemic relapse, the present case was noticeable. J Korean Ophthalmol Soc 2011;52(2):250-254

키워드

Acute myeloid leukemia, CNS involvement of leukemia, Optic disc edema