Acute Bilateral Vision Loss

Aderman, Christopher M.; Schwartz, Daniel M.

doi:10.1001/jamaophthalmol.2015.3572

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Only 10%-15% of cases are reported to occur in patients below 40 years of age [2]. Given the rare occurrence of simultaneous bilateral CRVO in a previously healthy patient, further testing was prompted to assess for common causes for serum hyperviscosity, such as Waldenstrom's macroglobulinemia, hyperhomocysteinemia, multiple myeloma, acute myeloid leukemia (AML), polycythemia, and chronic myeloid leukemia (CML), revealing our patient's underlying oncologic disease process, ALL [3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the diffuse retinal hemorrhages seen in CRVO, retinal hemorrhages in leukemic retinopathy are usually isolated in the posterior pole [13]. While leukemic retinopathy is more commonly recognized after the diagnosis of leukemia is established, it can represent early signs of disease or relapse [3,6,8].…”

Section: Discussionmentioning

confidence: 99%

“…CRVO risk factors include hypertension, diabetes, hyperlipidemia, and glaucoma. Retinal vein occlusion can occur in hyperviscous or leukostatic conditions such as acute leukemia, polycythemia, or thrombocytosis, resulting in hypoxic tissue damage and vision loss [3,4]. CRVO is most commonly a unilateral presentation; thus, the rare occurrence of bilateral CRVO warrants consideration of an underlying hyperviscosity state.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rare Presentation of Bilateral Central Retinal Vein Occlusion and Leukemic Retinopathy in a Young Adult Diagnosed with T-cell Acute Lymphoblastic Leukemia

Uhr¹,

Thau²,

Chung³

et al. 2020

Cureus

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Simultaneous bilateral central retinal vein occlusion (CRVO) is a rare presentation that warrants consideration of an underlying hyperviscosity state. Increased serum viscosity can lead to the hematologic emergency of leukostasis with resultant vascular obstruction and hypoxic tissue damage. The following case demonstrates the first case of bilateral CRVO in a young adult secondary to acute lymphoblastic leukemia (ALL). A 23-year-old female presented to the emergency department (ED) with two days of worsening bilateral blurry vision and bitemporal headache. Her ocular exam was significant for bilateral intraretinal hemorrhages consistent with CRVO with chest radiograph demonstrating widened mediastinum with perihilar lymphadenopathy and serologic testing revealing ALL with blast crisis. The patient was subsequently admitted to the oncology service for induction chemotherapy. Patients with new headache and bilateral vision changes should prompt a thorough neurological and ophthalmologic exam to assess for underlying systemic pathologies. Concurrent bilateral CRVO is a rare but specific finding for systemic hyperviscosity syndrome, blood dyscrasia, polycythemia, or other serious illness. Early recognition and treatment of the underlying condition can prevent further vision loss and overall morbidity and mortality.

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