Abstract: Restricted diffusion in the optic nerve detected with MRI has been previously reported in infarction and inflammation but not in infiltrative neoplasm. We report a 44-year-old man with recently diagnosed non-Hodgkin B-cell lymphoma who developed an acute left optic neuropathy. MRI showed no evidence of brain parenchymal or meningeal lymphoma but did show restricted diffusion in the intraorbital portion of the affected optic nerve. Despite treatment with corticosteroid, standard chemotherapy, and orbital X-irradiation, visual function did not improve. The restricted diffusion persisted on a follow-up MRI performed 4 months after the onset, a phenomenon that is atypical for infarction. Perhaps, this persisting imaging abnormality in lymphomatous optic neuropathy reflects the dense cellularity of the neoplasm.
Departments of Ophthalmology and Visual Sciences (PS) and Neurology (PS, JDT), W. K. Kellogg Eye Center; and Department of Radiology (FRR), University of Michigan Medical Center, Ann Arbor, Michigan.
The authors report no conflicts of interest.
Address correspondence to Jonathan D. Trobe, MD, Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI 48105 0714; E-mail: email@example.com