External Beam Radiotherapy for Bilateral Leukemic Infiltrative Optic Neuropathy in a Pediatric Patient

Abstract

Objective: To describe a rare case of acute lymphocytic leukemia (ALL) with optic nerve head tumor cell infiltration treated with external beam irradiation.

Methods: This is a case report.

Results: A 13-year old female with ALL complaining of blurred vision was found to have leukemic optic nerve head infiltration as evidenced by the presence of bilateral large, poorly-circumscribed, white masses covering the optic discs. She underwent external beam radiotherapy with total dose of 3000cGy. Four months posttreatment, there was marked reduction in tumor bulk with corresponding partial but significant visual improvement. No post-radiation complications were noted.

Conclusion: External beam irradiation is an effective treatment in reducing tumor bulk secondary to leukemic infiltration of the optic nerve with no significant collateral damage to adjacent ocular and periocular tissue. Early intervention is warranted to maximize visual recovery