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Bilateral Orbital Proptosis and Corneal Ulcer in a Child with Acute Myeloid Leukemia
Made Susiyanti1, Burhana Mawarasti1, Sesaria Rizky Kumalasari1
1Department of Ophthalmology, Cipto Mangunkusomo - Kirana Hospital, Universitas Indonesia, Jakarta, Indonesia.
Insights
A 5-year-old girl presented with bilateral proptosis and blurred vision, diagnosed with acute myeloid leukemia-M2. Chemotherapy resolved the eye protrusion, leaving a corneal scar.
Area of Science:
- Hematology
- Ophthalmology
Background:
- Acute myeloid leukemia (AML) can present with extramedullary manifestations.
- Ocular involvement in pediatric leukemia requires prompt diagnosis and management.
Observation:
- A 5-year-old girl exhibited bilateral proptosis, blurred vision, anemia, hyperleukocytosis, and thrombocytopenia.
- Severe protrusion of conjunctival, palpebral, and infraorbital tissues was noted, more pronounced in the left eye, with lagophthalmos and corneal defects.
Findings:
- Bone marrow aspiration confirmed acute myeloid leukemia-M2.
- Treatment with multiagent chemotherapy and topical antibiotics led to proptosis resolution within 4 months.
Implications:
- This case highlights the importance of considering hematological malignancies in pediatric proptosis.
- Early leukemia treatment can reverse ocular symptoms, though residual corneal damage may occur.
Abstract:
A 5-year-old girl had a 2-week history of protruding bilateral eye with blurred vision. The patient had a history of low-grade fever. Bilateral proptosis with a markedly severe protrusion of the conjunctival palpebral and infraorbital tissues was observed. A more pronounced proptosis occurred on the left eye. Lagophthalmos and corneal defects were found in the left eye. Laboratory tests revealed anemia, hyperleukocytosis, and thrombocytopenia. A confirmed diagnosis of acute myeloid leukemia-M2 was established from bone marrow aspiration. The patient was treated with standard multiagent chemotherapy and topical antibiotic eyedrops. Proptosis had resolved in 4 months with residual corneal cicatrix in the left eye.
