A person in his late 50s with just lately recognized power lymphocytic leukaemia (CLL) developed quickly progressive bilateral, painless imaginative and prescient loss. Regardless of important visible impairment, preliminary fundus examination, optical coherence tomography and neuroimaging had been largely unremarkable. Additional investigation revealed visible discipline defects, optic nerve dysfunction on visible evoked potentials and cerebrospinal fluid (CSF) infiltration by leukaemic cells, confirming bilateral leukaemic optic neuropathy (LON). The affected person was handled with high-dose intravenous methylprednisolone adopted by ibrutinib, leading to marked visible restoration and normalisation of visible fields. Momentary discontinuation of ibrutinib as a consequence of neutropenia led to symptom recurrence and chronic central nervous system infiltration, which improved after therapy was resumed. This case highlights the diagnostic challenges of LON, notably when ophthalmic and imaging findings are initially regular, and underscores the significance of CSF evaluation and immediate CLL-directed remedy to stop irreversible visible loss and obtain beneficial outcomes.
Key phrases:
Neuroopthalmology; Visible pathway.
