Bilateral optic dik edema and blindne a initial preentation of acute lymphocytic leukemia

PURPOE: To report bilateral optic dik edema and blindne a the unuual initial preentation of acute lymphocytic leukemia (ALL) in an adult. METHOD: A 19-year-old man preented with a hitory of headache, back pain, and 10 day of worening viion that progreed to blindne. Ocular examination revealed light perception acuity in the right eye and no light perception in the left eye. Fundu examination revealed bilateral profound optic dik edema, tortuou veel, and retinal hemorrhage. Acute lymphocytic leukemia wa diagnoed with complete blood count and bone marrow biopy. Head computed tomography and magnetic reonance imaging, were normal. Lumbar puncture revealed normal opening preure. Ocular ultraonography howed bilateral optic nerve enlargement. DEIGN: Interventional cae report and literature review. REULT: The preumptive diagnoi of leukemic infiltration of the optic nerve wa made, and urgent radiotherapy, intrathecal methotrexate, and intravenou daunorubicin were intituted. Viual acuity improved to hand motion in the right eye. CONCLUION: Acute lymphocytic leukemia can rarely preent in adult a viual change due to leukemic optic nerve infiltration. Radiation treatment hould be conidered a an urgent treatment modality for thi rare condition.