Optic Disc Infiltration as a First Sign of Acute Lymphoblastic Leukemia Relapse: A Case Report

This case report presents a unique manifestation of relapsed B-cell Acute Lymphoblastic Leukemia (ALL) involving the ocular system. This study contributes to the scientific literature by providing documented evidence of ocular complications, specifically central retinal vein occlusion (CRVO), central retinal artery occlusion (CRAO), and optic nerve infiltration, in a patient experiencing the relapse of ALL.

A 17-year-old male with a history of B-cell ALL presented with decreased vision in the right eye. Clinical examination revealed CRVO, CRAO, and optic nerve infiltration by leukemic cells. Imaging studies confirmed the presence of a retro-orbital mass and subretinal choroidal involvement. Bone marrow aspiration and biopsy confirmed relapsed of ALL. The patient was subsequently referred for further management.

This case highlights the importance of considering ocular manifestations, such as CRVO, CRAO, and optic nerve infiltration, in patients with relapsed ALL. Ophthalmological evaluation should be included in the follow-up and management of ALL patients to detect and manage ocular complications promptly. Early recognition and treatment of ocular manifestations can improve outcomes and quality of life for these patients.