Ophthalmological Manifestations in Acute Lymphoblastic Leukemia

Mateo, Javier; Ascaso, Francisco J.; Núñez, E.; Peiro, C; González, G. García; Cristobal, Ja

doi:10.5772/28012

Cited by 10 publications

(14 citation statements)

References 65 publications

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“…In acute leukaemia, ocular manifestation can be due to direct infiltration by the leukaemic cells or secondary to haemotological anomalies (Sharma, Grewal, Gupta, & Murray, 2004). Direct infiltration affects ocular structure such as orbital adnexal, iris, choroid and optic nerve (Mateo et al, 2011). Orbital infiltration is more common in ALL (Cardone, Yen, Chévez-Barrios, Foroozan, & Yen, 2006).…”

Section: Discussionmentioning

confidence: 99%

Sight Threatening or Life Threatening: A Case Report of Ocular Manifestation in Acute Lymphoblastic Leukaemia

Tan

Royan²,

Khairy-Shamel³

2019

IJPHCS

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Background: Acute lymphoblastic leukaemia (ALL) is the commonest childhood malignancy and ocular manifestations are uncommon in ALL. Patients may present with non-specific systemic symptoms which are overlooked and life threatening symptoms of leukostasis often present late. Here, we present a rare case of ALL where ocular symptoms preceded constitutional symptoms. Materials and Methods: A case report. Result: A 11-year-old girl presented with a syncopal attack during the fasting month to a primary health center. She was investigated at a tertiary center and diagnosed to have ALL. Further history revealed she had sudden painless severe reduced vision in the right for one month prior to this. Ocular assessment noted her right visual acuity was 5/60 and left visual acuity was 6/6. Her right fundus had a large subhyaloid haemorrhage over the macula and multiple large white-centered haemorrhages (Roth's spot); while the left fundus showed multiple large Roth's spots and some intraretinal haemorrhages. Chemotherapy was instituted after immunophenotyping was reported as precursor B-cell ALL. Ocular condition was managed conservatively. There was total resolution of the subhyaloid haemorrhage and retinal haemorrhages in both eyes and she regained full vision bilaterally while on induction therapy over 5 months. Conclusion: Life threatening conditions such as ALL should be considered in children with sudden, painless, reduced vision and urgent ophthalmology assessment is important for early detection. Blurry vision could be the earliest symptom in ALL. Awareness on eye health must be emphasized in school by the educators for early detection of both sight and life threatening condition among children.

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Section: Discussionmentioning

confidence: 99%

Sight Threatening or Life Threatening: A Case Report of Ocular Manifestation in Acute Lymphoblastic Leukaemia

Tan

Royan²,

Khairy-Shamel³

2019

IJPHCS

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“…The most common site of ophthalmic involvement is the retina. 4,[8][9][10] Common retinal manifestations of ALL include venous dilatation and tortuosity, white centered retinal hemorrhages and cotton wool spots. 10 Serous retinal detachment and optic disc swelling are less common.…”

Section: Discussionmentioning

confidence: 99%

Proliferative Leukemic Retinopathy With Bilateral Exudative Retinal Detachments and Optic Disc Swelling in a Patient With Acute Lymphoblastic Leukemia

et al. 2019

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Introduction: To report a patient with acute lymphoblastic leukemia (ALL) who developed proliferative leukemic retinopathy with bilateral exudative retinal detachments and optic disc swelling. Case Report: A 11-year-old girl diagnosed with ALL-L2 on maintenance chemotherapy presented with severe blurred vision in both eyes for the past 1 year. Her visual acuity was 0,5/60 for both eyes. Slit-lamp examination of the anterior segment was found normal. Dilated fundus examination revealed tortuous retinal vessels, retinal haemorrhage, retinal and optic disc neovascularizations, optic disc with indistinct margins, and total retinal detachments in both eyes, as well as vitreous haemorrhage in the left eye. The ultrasonography examination revealed bilateral subretinal fluid. Discussion: The patient was diagnosed with bilateral proliferative leukemic retinopathy with exudative retinal detachments and infiltrative optic neuropathy, and left eye vitreous haemorrhage due to ALL. Conservative treatment was given. She continued the maintenance chemotherapy from pediatric department. After 2 months follow up, the visual acuity did not improve although retinal detachments were reduced. There were atrophic changes at the retina of her both eyes. Conclusion: It was reported a rare case of proliferative leukemic retinopathy with bilateral exudative retinal detachments and optic disc swelling. Early recognition and treatment is crucial to improve prognosis.

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“…The main risk factor for chorioretinitis caused by Candida infections is fungemia with Candida albicans, as non-albicans species do not cause chorioretinitis. 4 Other risk factors include multiple positive blood cultures for Candida albicans, visual symptoms, and compromised immunity. 4 The fundus lesions in this case appeared as multifocal, well-circumscribed, whitish, creamy choroid lesions with a histoplasmosis-like appearance.…”

Section: Discussionmentioning

confidence: 99%

“…4 Other risk factors include multiple positive blood cultures for Candida albicans, visual symptoms, and compromised immunity. 4 The fundus lesions in this case appeared as multifocal, well-circumscribed, whitish, creamy choroid lesions with a histoplasmosis-like appearance. What is interesting about the lesions in this case is that they differ from the typical appearance of Candida fungus balls, vitritis, chorioretinitis, and endophthalmitis, which are more commonly encountered in candidal infections of the eye.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Case of Multifocal Choroiditis Secondary toCandida albicansInfection in a Leukemic Child

Santiagu¹,

Ong²,

Ariffin

et al. 2013

Ocular Immunology and Inflammation

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Ophthalmological Manifestations in Acute Lymphoblastic Leukemia

Cited by 10 publications

References 65 publications

Sight Threatening or Life Threatening: A Case Report of Ocular Manifestation in Acute Lymphoblastic Leukaemia

Sight Threatening or Life Threatening: A Case Report of Ocular Manifestation in Acute Lymphoblastic Leukaemia

Proliferative Leukemic Retinopathy With Bilateral Exudative Retinal Detachments and Optic Disc Swelling in a Patient With Acute Lymphoblastic Leukemia

A Case of Multifocal Choroiditis Secondary toCandida albicansInfection in a Leukemic Child

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