A high-pressure situation

Surv Ophthalmol. 2023 Jul-Aug;68(4):815-820. doi: 10.1016/j.survophthal.2022.08.001. Epub 2022 Aug 12.

Abstract

An 8-year-old boy presented with acute visual loss in the right eye and nausea, vomiting, and diplopia. Imaging revealed a right orbital apex mass. Biopsy showed Langerhans cell histiocytosis (LCH), and the patient was diagnosed with isolated orbital LCH causing an orbital apex syndrome. A 12-month cytarabine chemotherapy course was begun, during which the patient developed bilateral optic disc edema. He was diagnosed with cytarabine-induced intracranial hypertension, which was successfully treated with acetazolamide. The cytarabine course was completed with complete resolution of the LCH lesion. The ophthalmologic relevance of this rare disorder is discussed.

Keywords: Cytarabine; Intracranial hypertension; Langerhans cell histiocytosis (LCH); Orbital apex syndrome.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Cytarabine / adverse effects
  • Diplopia
  • Histiocytosis, Langerhans-Cell* / diagnosis
  • Histiocytosis, Langerhans-Cell* / drug therapy
  • Histiocytosis, Langerhans-Cell* / pathology
  • Humans
  • Male
  • Orbital Diseases* / diagnosis
  • Orbital Diseases* / drug therapy
  • Orbital Diseases* / pathology
  • Papilledema* / chemically induced
  • Papilledema* / diagnosis
  • Papilledema* / drug therapy

Substances

  • Cytarabine