DR. ANIZA NAGPAL

DR. BRUTTENDU MOHARANA, DR. RIA SHARMA, DR. BHAVANA SHARMA

Abstract

A 55 year old diabetic and hypertensive male presented with sudden decrease in vision in Right eye since 3 days. BCVA was 6/36 with Relative afferent pupillary defect and dyschromatopsia in Right eye. Fundus showed marked unilateral Optic disc edema with peripapillary hemmorhages with OCT average RNFL thickness of 245 µm in Right Eye. A provisional diagnosis of Non Arteritic Ischemic Optic Neuropathy was made. Screening blood tests advised showed TLC of 156*10³/µL with Blast cells 6%, Myelocytes 16%, Metamyelocytes 11%. BCL-ABR rearrangement PCR and Bone marrow biopsy were confirmatory of CML. The patient was started on Oral Steroids, Imatinib and hydroxyurea. After 4 weeks of treatment, BCVA (OD) improved to 6/12 with decrease in OCT average RNFL thickness to 102µm. Optic neuropathy is usually associated with CML but it is rarely the presenting feature of CML. Our case report documents one such rare scenario that emphasizes on considering Leukemias as a cause of optic neuropathy.