Bilateral retinal hemorrhages in an 18-year-old woman

A previously healthy 18-year-old woman presented with sudden onset of central blurred vision in the right eye. Fundoscopic examination showed retinal venous tortuosity, several flame-shaped hemorrhages bilaterally, and a subhyaloid hemorrhage in the right fovea. Laboratory evaluation and subsequent bone marrow biopsy were consistent with the diagnosis of acute lymphoblastic leukemia. The retinal findings had cleared almost completely by three weeks after initiation of chemotherapy.