Bilateral Hypopyon Uveitis in Chronic Myeloid Leukemia.

Area of Science:

• Ophthalmology
• Hematology
• Oncology

Background:

• Leukemic hypopyon can indicate early central nervous system (CNS) involvement or systemic relapse.
• Atypical or treatment-resistant hypopyon uveitis warrants consideration of masquerade syndromes.
• This case details a 45-year-old man with bilateral hypopyon uveitis later diagnosed with chronic myeloid leukemia (CML).

Purpose of the Study:

• To report a case of bilateral hypopyon uveitis as an initial presentation of chronic myeloid leukemia (CML) in blast crisis.
• To emphasize the importance of considering hematologic malignancies in atypical hypopyon uveitis cases.
• To highlight the diagnostic value of unusual hypopyon findings in identifying systemic disease.

Main Methods:

• Retrospective case review.
• Ophthalmic evaluation including visual acuity, slit-lamp examination, and funduscopy.
• Peripheral blood smear and bone marrow trephine biopsy for hematologic diagnosis.

Main Results:

• A 45-year-old male with diabetes presented with bilateral hypopyon uveitis and signs of proliferative diabetic retinopathy.
• The patient developed a bloodstained hypopyon, prompting further investigation.
• Diagnosis of chronic myeloid leukemia (CML) in blast crisis was confirmed via peripheral blood smear and bone marrow biopsy.

Conclusions:

• Recalcitrant or atypical hypopyon uveitis may indicate blast crisis or CNS involvement in leukemia patients.
• The presence of a bloodstained hypopyon was crucial in diagnosing CML and facilitating prompt oncologic consultation.
• This case underscores the necessity of a broad differential diagnosis for hypopyon uveitis, including hematologic malignancies.