Abstract:

 Objective  To investigate the clinical and imaging features of patients with hematologic system tumors who initially presented to neuro-ophthalmology departmnt. Design  Retrospective case series. Participants Three cases initially presented as optic neuropathy, which was confirmed as hematological malignancy finally. Method  The data including clinical manifestations, imaging examinations, laboratory tests and pathological findings of the patients were retrospectively analyzed. Main Outcome Measures  Clinical manifestations, magnetic resonance imaging (MRI) of brain or orbit, blood and cerebral spinal fluid (CSF) tests and pathological findings. Results  The three patients were over 50 years of age. Two patients complained with vision loss, one patient complained with amaurosis fugax bilateral. Orbital MRI showed the optic nerve thickening and different degree of enhancement in two cases of lymphoma, and involvement of optic nerve and optic chiasm without obvious enhancement in multiple myeloma. All the patients underwent biopsy and the outcomes were confirmed by pathology. One case was diagnosed as diffuse large B cell lymphoma, one as small B cell lymphoma and the other case as multiple myeloma. Conclusion  This study documented three extremely rare cases of hematologic tumors initially presented as optic neuropathy. Blood tests and imaging examinations are helpful to making the diagnosis. Pathological examination is the gold standard for diagnosis. (Ophthalmol CHN, 2017, 26: 338-342)

Key words: optic nerve, lymphoma, myeloma