Ocular leukemia in King Abdulaziz University Hospital - Jeddah

To the best of our knowledge, ocular leukemia has not been reported in Saudi Arabia. Seventy-two leukemia patients were seen in King Abdulaziz University Hospital in Jeddah over the last 10 years. Thirty-one of those patients had an ocular examination. Seventeen of these were found to have ocular abnormalities related to leukemia. Ten had acute lymphoblastic leukemia, four had acute myeloid leukemia and three had chronic myeloid leukemia. The retina and vitreous were involved in 12 of the ocular relapses, the anterior segment leukemic infiltrate in nine, glaucoma in five, opportunistic infection in four, cranial nerve palsies in three, proptosis and hypotony in two. Conjunctival hemorrhage, choroidal infiltrate and cataract were present in one relapse each. The optic nerve was involved in nine relapses, which is a serious condition that requires immediate intervention to save the patient's sight. Computed tomography (CT) scan of the brain and orbit was useful in differentiating between optic nerve infiltrate and papilledema. Most ocular relapses responded well to chemotherapy except relapses with optic nerve and anterior segment infiltrate, which required irradiation to save the patient's sight and prevent further relapses. In conclusion, the presented data have shown that ocular leukemia is not rare and emphasizes the importance of early ophthalmologic examination and radiation.