Ischemic Optic Neuropathy Secondary to Intravascular Lymphoma

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Title Ischemic Optic Neuropathy Secondary to Intravascular Lymphoma
Creator Marc Dinkin; Ehud Lavi; Jacqueline Winterkorn; Cristiano Oliveira; Alexander E. Merkler
Affiliation Departments of Ophthalmology (MD, JW, CO), Neurology (MD, AEM), and Pathology (EL), Weill Cornell Medical College, New York, New York
Abstract Background: To describe a case of optic neuropathy associated with intravascular lymphoma (IVL). Methods: Case report and review of the literature. Results: A case of asymmetric binocular vision loss is described, preceded by transient vision loss. Associated optic perineural enhancement and enhancing and diffusion-positive cortical lesions were observed on magnetic resonance imaging. Biopsy of the cerebellum revealed exclusively intraluminal neoplastic B-cells consistent with IVL.Conclusions: Patients with IVL may rarely present with optic nerve involvement, presumably due to small vessel occlusion. The presentation may mimic features of anterior ischemic optic neuropathy including an acute onset and disc edema. Although optic nerve enhancement and associated white matter lesions may suggest optic neuritis, enhancement of the optic nerve sheath, as in this case, has a wide differential diagnosis, which includes giant cell arteritis. IVL should be considered in atypical cases of optic neuropathy accompanied by enhancing, diffusion-positive brain lesions that are not within a specific vascular territory.
Subject Aged; Brain / diagnostic imaging; Female; Humans; Lymphoma / complications; Lymphoma / diagnostic imaging; Optic Nerve / diagnostic imaging; Optic Neuropathy, Ischemic / diagnostic imaging; Optic Neuropathy, Ischemic / etiology; Temporal Arteries / diagnostic imaging; Ultrasonography; Vascular Neoplasms / complications; Vascular Neoplasms / diagnostic imaging
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Date 2019-09
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, September 2019, Volume 39, Issue 3
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6cc6q7t
Setname ehsl_novel_jno
ID 1595894
Reference URL https://collections.lib.utah.edu/ark:/87278/s6cc6q7t
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