Atlas of Hematology

Unilateral Exudative Retinal Detachment as the Sole Presentation of Relapsing Acute Lymphoblastic Leukemia
Ocular findings are rarely the initial symptom of leukemia, although up to 90% of all leukemia patients have fundus changes during the course of the disease. Herein we report a relapsing acute lymphoblastic leukemia patient with the sole presentation of sudden visual loss and exudative retinal detachment. An 8-year-old boy with acute lymphoblastic leukemia developed sudden visual loss during his first remission period. Bullous retinal detachment with total afferent pupillary defect was observed. Orbital magnetic resonance imaging revealed an intraocular mass lesion; simultaneously obtained bone marrow and cerebrospinal fluid samples showed no evidence of leukemic cells. Following local irradiation, and systemic and intrathecal chemotherapy the mass disappeared. Local irradiation, and systemic and intrathecal chemotherapy effectively controlled the isolated ocular relapse of acute lymphoblastic leukemia and eliminated the need for enucleation.

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Authors: Fatih Mehmet Azık, Arsen Akıncı, Tülin Revide Şaylı, Vildan Kosan Çulha, Kuddusi Teberik, Mehmet Yasin Teke, Fatih Gürbüz

Keywords: Akut lenfoblastik lösemi, Eksudatif retina dekolmanı, Relaps

Year: 2012
Number: 2
Referance No: 72623

Figure 1: Slit-lamp photograph of the left eye at presentation shows exudative retinal detachment.
Figure 2: Orbital MRI shows a 2 x 1.5-cm mass lesion with irregular borders completely filling the bulbus oculi.
Figure 3: MRI shows crescent-shaped fibrotic tissue in the posterior region of the left bulbus oculi, which was considered calcification without evidence of a mass.