Sir,
We greatly appreciate the prompt response of Bandhopadhyay et al. to the queries raised in our article “Optic nerve infiltration in relapse of acute lymphoblastic leukemia.”[1]
We totally agree with the authors that unilateral optic nerve infiltration in leukemia may occur in the presence of normal complete blood count and bone marrow examination. But this is still very rare even if we go along with the notion that such cases are underreported. Such cases are exceptional rather than regular for obvious reasons. We do, however, agree like many others[2,3] that periodic ophthalmic examinations should be conducted in patients with acute leukemia.
We thank the authors for providing an explanation for the possible causes of subnormal vision in such patients and also for appropriately highlighting the radiological features of central nervous system of the case reported by them.[4]
References
- 1.Ali MJ, Honavar SG. Optic nerve infiltration in relapse of acute lymphoblastic leukemia. Oman J Ophthalmol. 2011;4:40. doi: 10.4103/0974-620X.77665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Shields JA, Shields CL. Intraocular leukemia. In: Shields JA, Shields CL, editors. Intraocular Tumors- A Text and Atlas. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2007. pp. 530–4. [Google Scholar]
- 3.Kassam F, Gale JS, Sheidow TG. Intraocular leukemia as a primary manifestation of relapsing acute myelogenous leukemia. Can J Ophthalmol. 2003;38:613–6. doi: 10.1016/s0008-4182(03)80120-5. [DOI] [PubMed] [Google Scholar]
- 4.Bandyopadhyay S, Das D, Das G, Gayen S. Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission. Oman J Ophthalmol. 2010;3:153–4. doi: 10.4103/0974-620X.71902. [DOI] [PMC free article] [PubMed] [Google Scholar]
