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Purpose Acute lymphoblastic leukemia is a severe affection related to invasion of the bone marrow by immature haematopoietic cells of the lymphoid lineage. Retinal hemorrhages with white center are secondary to a specific pathophysiological mechanism. They are exceptional when revealed acute leukemia. Methods Through clinical observation of a case of acute lymphocytic leukemia revealed by retinal hemorrhages with white center, we recall the pathophysiological mechanisms and clinical aspects of this rare retinal disease. Results A 16 years old child consult for myodesopsia in his left eye. The ophtalmological examination show a correct visual acuity 10/10 P2 in the right eye and 9/10 P2 in the left. We note a discolored conjunctiva with vascular occlusions. The examination of the fundus of eyes reveal a diffuse retinal hemorrhages with white center. The blood count analysis show ; 120.000/mm3 WBC, Hb 3.5 g / dl and platelet 37.000/mm3. The diagnosis of acute lymphoblastic leukemia is made. The child is cared for in a pediatric oncology service. He received a blood transfusion and chemotherapy with complete remission at the last control. Conclusion Ophthalmologic examination has a major interest in the diagnostic and therapeutic management of this disease.

Purpose Multifocal choroiditis is an idiopathic posterior uveitis. It combines small white spots in fundus of eye and recurrent intraocular inflammation. Some biological or radiological manifestations of sarcoidosis may be found in these patients. Methods We report a case of severe multifocal choroiditis associated with systemic granulomatosis. The aim of our study was to describe the clinical and therapeutic aspects, and discuss the etiopathogenic approach of this rare entity. Results A 45 years old women who consults for blurred vision. Visual acuity is reduced at 1/20 P8 in right eye and 3/10 P5 in the left. There is a hyalite + bilaterally. Peri papillary atrophy, hemorrhage around the macula, multiple white and pigmentis small spots was found in fundus of eyes. Retinal thickening and involvements of the pigment epithelium and choroid are revealed by macular OCT in the right eye. The fluorescein angiography show hypofluorescence of chorioretinal spots in early time, a window effect scarring and bilateral papillitis. The ECA is 74 UECA. Chest scan reveal a non specific parenchymal micronodules. The patient received systemic corticosteroids. Control OCT show a subretinal fibrosis explaining the introduction of immunosuppressant treatment. The final visual acuity is 1/10 right and 12/10 left with a decline of 3 years. Conclusion Although intraocular manifestations of multifocal choroiditis, it most correspond to a systemic granulomatosis near sarcoidosis.