Surgical management of a case of severe leukemic retinopathy

To present a case of severe leukemic retinopathy requiring surgical rehabilitation. We report four-year follow up and associated post-remission pathology including cystoid macular edema (CME) and retinal ischemia.

This is a case report of a 35-year-old female with acute myelocytic leukemia (AML) who presented with hand motions (HM) vision in both eyes and severe multilayered hemorrhages. She underwent pars plana vitrectomy (PPV) in the left eye and subsequent PPV with internal limiting membrane (ILM) peel in the right eye after autologous bone marrow transplant. After cataract surgery and treatment of CME, visual acuity improved to 20/25 in each eye. Fundus examination and optical coherence tomography (OCT) revealed outer retinal loss outside of the fovea.

Surgical intervention can be necessary for visual rehabilitation in some patients with leukemic retinopathy. With improved medical treatment for AML, patients survive longer, making visual rehabilitation more impactful and allowing for a better understanding of the natural history of leukemic retinopathy.