Retinal arterial macroaneurysm in leukemia

Retinal arterial macroaneurysm (RAM) is an acquired vascular dilatation usually seen at the site of arterial bifurcation or arterial-vein crossing. It's often seen in the first three branches of the central retinal artery.

A 15-year-old male patient was admitted to the outpatient clinic with complaints of weakness, headache, and bruising on the body for a few weeks. During the physical examination, a hepatomegaly and a common patchy ecchymosis in the body were detected at the abdominal examination. Hemoglobin was 6.6 g/dl, white blood cells were 40,000/mm³, platelet was 24,000/mm³ at the whole blood count done. The 70% blast was detected in peripheral spread. Bone marrow aspiration evaluation was consistent with pre-B cell acute lymphoblastic leukemia. There was two macroaneurysms in the inferior arcuate of the left eye. The patient was examined on a weekly basis. During control examinations, retinal macroaneurysms in left eye and the hemorrhages significantly regressed.

The fact that RAM is not often seen in the pediatric age group, indicates the importance of this phenomenon. It should be remembered that a complete ophthalmic examination should be performed on leukemia patients.