Bilateral primary optic nerve lymphoma

A 69-year-old man was examined for bilateral infiltrative optic neuropathy. Optic nerve biopsy confirmed a malignant B cell lymphoma. Systemic examination and investigations failed to show involvement of other sites.     

Isolated metastasis to the optic nerve

A case of isolated optic nerve metastasis from breast carcinoma is described. Intraocular tumor was discovered three months following a radical mastectomy and was confined to the optic nerve head and distal optic nerve. Following X-irradiation treatment, central retinal vascular occlusion, rubeosis, and neovascular glaucoma developed during the fifteen months before enucleation. The clinicopathologic features of this case are discussed and the literature reviewed.     

Isolated aplasia of the optic nerve

The results of ophthalmologic examinations, including ophthalmoscopy, ultrasound Doppler-graphy as well as neuroradiological and electrophysiological investigations, of a 6-month boy with bilateral isolated aplasia of the optic nerve are described. The discussion comprises a literature survey dedicated to pathogenesis and diagnostics of optic-nerve aplasia in children.     

Orbital lymphoma mimicking optic nerve meningioma

purpose To describe two patients with orbital lymphoma mimicking optic nerve meningioma. methods Retrospective case review. results Both patients presented in their sixth decade with gradually increasing proptosis and decreasing vision. Computerized tomography revealed homogeneous masses encasing the optic nerves, which in conjunction with the clinical presentations were felt to represent optic nerve meningiomas. Biopsy, however, led to a diagnosis of lymphoma of mucosal-associated lymphoid tissue origin in one and a well-differentiated non-Hodgkin's lymphoma in the other. conclusion Orbital lymphoma surrounding the optic nerve may mimic the clinical and radiological appearance of an optic nerve meningioma.     

Isolated metastasis to optic nerve from medulloblastoma

Isolated involvement of the optic nerve with metastatic tumor is uncommon. A 19-year-old man had a midline cerebellar medulloblastoma; a gross total removal was performed. He received postoperative radiation therapy to the whole brain, posterior fossa, and craniospinal axis. A progressive optic neuropathy developed 28 months later with radiologic evidence of an enlarged optic nerve. There was no evidence of metastatic disease elsewhere. An optic nerve biopsy showed metastatic medulloblastoma. An intramedullary metastasis developed 48 months after the primary diagnosis, and the patient died 5 months later.     

Isolated oculomotor nerve palsy in malignant lymphoma

We report the clinical features of isolated oculomotor nerve palsy in patients with malignant lymphoma. A retrospective evaluation of five patients was performed. Their ages ranged from 43 to 77 years (average: 64.5 years). All histopathologic types were non-Hodgkin's lymphoma, in particular B-cell type in four patients. Oculomotor nerve palsy was unilateral in all five patients and the pupil was spared in four. Leptomeningeal dissemination of malignant lymphoma was detected in three patients. However, neuroimaging could not locate the lesion responsible for the oculomotor nerve palsy in any patient. Despite chemotherapy, all patients died within nine months after the appearance of oculomotor nerve palsy. In malignant lymphoma, isolated oculomotor nerve palsy is unilateral, pupil-sparing, and a poor prognostic sign.     

Presumed optic nerve sheath meningioma diagnosed after complicated retrobulbar anesthesia

We present a patient who developed acute visual loss and light flashes at retrobulbar anesthesia for cataract extraction. Vision improved only slightly after cataract surgery. Although traumatic optic neuropathy was suspected, the patient was diagnosed one year later with an optic nerve sheath meningioma (ONSM). ONSM is a rare, slow growing, benign tumour with highly variable clinical features. Diagnosis is often delayed. This case report demonstrates the diagnostic difficulty of this tumour.     

Uveal melanomas with optic nerve extension: report of two cases diagnosed by transvitreal biopsy, one of them with a multicentric tumour

PURPOSE: To report two cases of invasive uveal melanomas, one of which showed multifocality. METHODS: Clinical examination, ultrasonography, colour Doppler analysis, cytological and histopathological evaluations. RESULTS: Transvitreal biopsy (case 1) or fine needle aspiration biopsy (FNAB) (case 2) revealed malignant melanomas in both patients. Light microscopy and immunohistochemical examinations substantiated the diagnosis of mixed cell type melanomas. In addition, one patient had a multifocal melanoma with papilloedema and colour Doppler findings suggestive of optic disc involvement. CONCLUSION: Transvitreal biopsy for histology or cytology is a reliable procedure to obtain an accurate diagnosis without delay of a lesion adjacent to the optic nerve head. In our two cases the biopsy findings led to enucleation.     

Lepromatous uveitis diagnosed by iris biopsy

Ocular leprosy is rarely seen in developed countries. We report the long-term follow-up of a patient with bilateral uveitis, glaucoma, and keratitis. Skin, iris and aqueous humor biopsies disclosed abundant Wade-Fite-positive organisms consistent with Mycobacterium leprae. Leprosy must be considered in the differential diagnosis of keratitis and uveitis. Received: 24 July 1997 Revised version received: 13 January 1998 Accepted: 14 January 1998     

Malignant lymphoma involving the optic nerve head and the retina

A previously healthy 27-year-old man presented with a history of progressive paraplegia and blurred vision within one year. Physical examination revealed marked posterior column sign. Cerebrospinal fluid (CSF) contained a white blood count of 1,940 microL, all lymphocytes. Fundi revealed yellowish infiltration (candle-wax drippings) along retinal vessels and tumefaction of the optic nerve head. He was initially misdiagnosed as suffering from tuberculosis meningitis on the basis of the CSF findings. Sarcoidosis was then suspected because of the unusual fundus appearance. Malignant lymphoma was confirmed by inguinal lymph node biopsy.