[White-centered retinal hemorrhage revealing acute lymphoblastic leukemia]

Retinal involvement during leukemia is frequent (varying from 28% to 50%), can be the result of different mechanisms, and may reveal the disease. We describe two patients, 10 and 50 years old, who consulted for a sudden drop in visual acuity. Fundus examination showed bilateral retinal hemorrhage with a white center in both eyes associated with other hemorrhages in the posterior pole. Acute leukemia was found in both patients and chemotherapy was institgated. The younger patient died of general complications, the other is in remission phase. Retinal hemorrhage with a white center is a rare manifestation of acute leukemia and is exceptionally the first sign of the disease. Through these cases, we detail the physiopathology and clinical aspects. We stress the importance of ocular findings in leukemia in both diagnosis and therapy.