Leukemic hypopyon

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Hematology

Background:

• Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
• Ocular complications can occur in patients with ALL, even during remission.
• Hypopyon, a collection of white blood cells in the anterior chamber, can be a sign of ocular inflammation or infiltration.

Observation:

• A seven-year-old girl in remission from ALL developed a monocular hypopyon.
• Initial treatment with topical and subtenons steroids was successful but the hypopyon recurred.
• Recurrence prompted diagnostic paracentesis.

Findings:

• Diagnostic paracentesis revealed leukemic cells in the aqueous humor.
• Aqueous lactate dehydrogenase levels were normal.
• Leukemic ocular infiltration can mimic neoplastic and inflammatory conditions.

Implications:

• Early and accurate diagnosis of ocular leukemia is crucial for effective treatment.
• Paracentesis combined with lactate dehydrogenase assay is a valuable diagnostic tool for ocular leukemia.
• This case highlights the importance of considering leukemic recurrence in patients with unexplained ocular findings.