A case of leukemic retinopathy mimicking common ischemic retinopathies

Awuah, Agnes; Asiedu, Kofi; Adanusa, Madison; Ntodie, Michael; Acquah, Michael E; Kyei, Samuel

doi:10.1002/ccr3.457

Cited by 15 publications

(22 citation statements)

References 11 publications

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“…The median age was 37.05 years (range 27.5-49), and 67.5 % of patients were male. Most of the cases were initial presentations of CML (33 cases), and only five of them were in relapses 4,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][25][26][27][28][29][30][31][32][35][36][37][39][40][41][42][43][44][45][46][47] . The retina was most often involved, with retinal hemorrhages as the most common finding.…”

Section: Resultsmentioning

confidence: 99%

“…12,17,20,22,27,32,33,39,42 Eight of these had unilaterallydecreased of vision, and 1 had normal vision. 12 Thirty-one patients presented with bilateral ophthalmic findings 4,[8][9][10][11][13][14][15][16]18,19,[23][24][25][26][28][29][30][31][32][34][35][36][37][38][40][41][42]44,46 . Four of these patients had normal vision upon presentation 9,13,24,34 , while 11 patients had unilateral decrease of vision 10,14,16,17,25,26,32,…”

Section: Discussionmentioning

confidence: 99%

“…1 Chronic phase (CML-CP) is defined as having evidence of t(9;22) or the BCR-ABL fusion gene, a blast count less than 10% in the bone marrow, and should not meet any criteria for accelerated phase or blast crisis as per the European Leukemia Network (ELN) guidelines. Accelerated phase (CML-AP) must meet one or more of the following criteria: blasts 15-29% of peripheral blood white cells or bone marrow cells, peripheral blood basophils at least 20%, or persistent thrombocytopenia (<100 ×10 9 /L) unrelated to therapy. The World Health Organization (WHO) criteria are slightly different with the addition of persistent thrombocytosis unresponsive to treatment and peripheral blood blasts 10-19% 2 .…”

Section: Introductionmentioning

confidence: 99%

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Ophthalmologic manifestations as the initial presentation of chronic myeloid leukemia: A review

Yassin

Ata

Mohamed

et al. 2022

Survey of Ophthalmology

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ophthalmologic manifestations as the initial presentation of chronic myeloid leukemia: A review

Yassin

Ata

Mohamed

et al. 2022

Survey of Ophthalmology

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“…The treatment for leukemic retinopathy does not involve any direct therapy. Chemotherapy, immunotherapy, and radiotherapy, however, are usually implemented to manage the underlying systemic cause [ 1 ]. In 2018, Lyu et al suggested that expectant management should be the first-line treatment of choice due to the higher risk of bleeding and infection in leukemic patients [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…AML is a complex disorder that arises in a malignantly hematopoietic stem cell and subsequently acquires successive genomic alterations, eventually developing into clinically overt disease. AML is the most common type of leukemia that affects adults [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

A Case of Acute Promyelocytic Leukemia With Retinal Hemorrhages Beneath Internal Limiting Membrane During Clinical Remission

Balubaid¹,

Alqahtani²

2021

Cureus

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Leukemia is a systematic cancer of the blood and blood-forming tissues that affects multiple organs. Acute myeloid leukemia (AML) is the most common type of leukemia that affects adults. Ophthalmic manifestations of leukemia could be observed in both acute and chronic leukemias. Around 35.4% of leukemia patients present with leukemic retinopathy. In this report, we discuss the case of a patient who was diagnosed with acute promyelocytic leukemia (APL) and went on to develop leukemic retinopathy during chemotherapy. A 35-year-old male was diagnosed with APL and received induction therapy with daunorubicin, and all-trans retinoic acid (ATRA) in a seven + three regimen. During the remission phase, he presented with a complaint of decreased vision of the right eye for about three weeks after the initiation of the therapy. On examination, the best-corrected visual acuity (BCVA) was found to be 6/60 in the right eye and 6/6 in the left eye. Fundus examination showed intraretinal hemorrhages in the posterior pole of both eyes. Fundus photography of the right eye showed resolved macular bleeding, temporal retinal bleeding, fresh inferonasal, and supraoptic retinal hemorrhage. For the left eye, however, it showed a small hemorrhagic spot temporal to the macula. Optical coherence tomography (OCT) was performed on both eyes, which showed sub-inner limiting membrane (sub-ILM) hemorrhage in the right macula with normal OCT of the left eye. There are multiple reported ocular manifestations of leukemic retinopathy including flame-shaped hemorrhage, cotton wool spots, and Roth spots. In patients with APL, thrombocytopenia and intracranial hemorrhage are the proposed underlying mechanism of retinal hemorrhage. Terson’s syndrome, which is an intracranial hemorrhage with associated retinal hemorrhage, has been reported to occur during ATRA induction therapy. Sub-ILM hemorrhage is relatively uncommon, and it has been associated with multiple primary pathologies such as Valsalva retinopathy, Terson’s syndrome, and bleeding dyscrasias. Retinal hemorrhage is a serious complication in leukemic patients; it could be the presenting complaint or even manifest after the initiation of therapy. Early detection and frequent follow-ups are crucial for its management.

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Retinal Hemorrhages in a Patient With Petechiae

2019

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A 44-year-old man with a 2-week history of fevers, night sweats, chills, and petechiae presented with painless, blurry vision in the left eye. His ocular symptoms began 2 days prior when he noticed dark scotomas in his central field and decreased visual acuity. There was no recent trauma or strenuous physical activity. He had no relevant medical, ocular, or family history, and he denied use of illicit drugs or anticoagulants.Uncorrected visual acuity was 20/30 OD and 20/400 OS. Extraocular motility and intraocular pressures were normal. Results of an anterior examination was unremarkable. Dilated funduscopic examination of the left eye revealed a pink optic nerve with sharp margins, diffuse intraretinal hemorrhages and Roth spots extending from the posterior pole to the far periphery, and preretinal hemorrhage overlying the central macula (Figure , A). Spectral-domain optical coherence tomography through the preretinal macular hemorrhage demonstrated layered blood in the sub-internal limiting membrane space (Figure , B). The right fundus exhibited a similar appearance aside from the preretinal hemorrhage.

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A case of leukemic retinopathy mimicking common ischemic retinopathies

Cited by 15 publications

References 11 publications

Ophthalmologic manifestations as the initial presentation of chronic myeloid leukemia: A review

Ophthalmologic manifestations as the initial presentation of chronic myeloid leukemia: A review

A Case of Acute Promyelocytic Leukemia With Retinal Hemorrhages Beneath Internal Limiting Membrane During Clinical Remission

Retinal Hemorrhages in a Patient With Petechiae

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