T-cell acute lymphocytic leukemia with bilateral optic nerve head infiltrates

Abstract

A 9-year-old male diagnosed with T-cell acute lymphocytic leukemia and defaulted chemotherapy presented with progressive visual decline OU. The patient denied perception of light OD and had a visual acuity of 20/200 OS. Fundus examination revealed massive optic nerve head infiltration of leukemic cells OU with combined occlusion of the central artery and vein with inferior exudative retinal detachment OD (Fig. 1A) and peripapillary circinate subretinal fluid accumulation OS (Fig. 1B). An emergency hemato-oncology review was done, and chemotherapy was reinitiated.