Acute response of orbital leukemia to radiation treatment: a case report

A 36-year-old male with acute myelocytic leukemia [AML] presented with rapidly developed, marked proptosis bilaterally. Bilateral lid retraction and reduced extraocular motility in all fields of gaze were present. Neuroimaging studies [CT and MRI] revealed diffuse enlargement of extraocular muscles in both eyes. The patient refused intravenous injection of any kind due to his religious beliefs and accepted treatment only by external beam radiation. He was treated with 20 Gy to each eye over a two-week period resulting in marked improvement of his orbital symptoms. Within one month after initial presentation his proptosis was dramatically reduced with full extraocular motility at all gazes