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Visual loss as initial presentation of chronic myelogenous leukemia
Blanka Doko Mandić1, Vlatka Potocnjak, Goran Bencić
1University Department of Ophthalmology, Clinical Hospital, Systers of Mercy, Zagreb, Croatia.
Collegium Antropologicum
|October 1, 2005
Summary
Sudden vision loss in a teen was linked to chronic myelogenous leukemia (CML). Prompt chemotherapy improved vision, highlighting leukemia as a key consideration for optic disc edema and retinal hemorrhages.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Ocular manifestations of hematologic malignancies are critical diagnostic indicators.
- Early detection of systemic diseases through ophthalmic findings can significantly alter patient outcomes.
Observation:
- A 17-year-old female presented with acute bilateral visual loss.
- Funduscopic examination revealed bilateral optic disc edema, retinal vascular changes, hemorrhages, and Roth spots.
- Laboratory results indicated a significantly elevated white blood cell count, leading to a diagnosis of chronic myelogenous leukemia (CML).
Findings:
- Ocular findings included optic disc edema, retinal venous tortuosity and dilatation, blot and flame-shaped hemorrhages, Roth spots, and a foveal preretinal hemorrhage.
- Bone marrow biopsy confirmed CML.
- Initiation of chemotherapy resulted in improved visual acuity and resolution of most fundus changes, though residual foveal maculopathy persisted.
Implications:
- This case underscores the importance of considering leukemia in the differential diagnosis of patients presenting with optic disc edema and retinal hemorrhages.
- Ophthalmic findings can be the initial presentation of CML, necessitating prompt hematologic evaluation.
- Timely diagnosis and treatment of CML can prevent irreversible visual impairment.