Isolated Optic Nerve Infiltration Revealing Lymphomatous Involvement in an Adolescent: A Case Report

Abstract

- Background: Optic nerve infiltration by lymphoma is an uncommon but sight-threatening complication that can occur in patients with systemic lymphoma during active chemotherapy. - Case Description: We report a 16-year-old patient with a history of lymphoma under active chemotherapy who presented with sudden left eye blindness and a relative afferent pupillary defect. Brain and orbital MRI demonstrated diffuse swelling, T2 hyperintensity, restricted diffusion, and contrast enhancement of the left optic nerve without intracranial parenchymal or meningeal involvement, highly suggestive of optic nerve neurolymphomatosis. - Conclusion: This case highlights the imaging features of isolated lymphomatous optic neuropathy and emphasizes the critical role of prompt contrast-enhanced MRI with diffusion-weighted imaging in oncologic patients presenting with acute vision loss.