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Bilateral leukemic orbital infiltration presenting as proptosis and narrow-angle glaucoma
Krishna Tumuluri1, Thomas Woo, Johnathon Crowston
1Cornea and EyePlastic Surgery Unit, Department of Ophthalmology, Western Sydney Eye Hospital, Westmead Hospital Westmead, Australia.
Ophthalmic Plastic and Reconstructive Surgery
|May 29, 2004
Summary
This case report details a rare instance of acute myeloid leukemia causing simultaneous orbital and ocular leukemic infiltration. The patient experienced tense proptosis and acute-angle closure glaucoma, which resolved with chemotherapy.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Acute myeloid leukemia (AML) can infiltrate ocular and orbital tissues.
- Leukemic infiltration of the orbit and uvea is uncommon, especially presenting simultaneously.
Observation:
- A 71-year-old man with AML presented with bilateral proptosis, orbital inflammation, and acute-angle closure glaucoma.
- Ocular ultrasound showed uveoscleral thickening and ciliary body rotation.
- Orbital imaging revealed bilateral proptosis with intraconal fat streaking.
Findings:
- The patient experienced tense proptosis and acute-angle closure glaucoma due to leukemic infiltration.
- Temporary pressure reduction was achieved via lateral canthotomy and inferior cantholysis.
- Systemic chemotherapy and steroids led to vision improvement, proptosis resolution, and normalized intraocular pressure within two weeks.
Implications:
- This case highlights a unique presentation of AML with simultaneous orbital and ocular leukemic infiltration.
- Early diagnosis and prompt systemic treatment are crucial for managing such rare presentations.
- Understanding this presentation aids in recognizing ocular emergencies in leukemia patients.