Bilateral macular serous retinal detachment revealing acute myeloblastic leukemia

Abstract

Purpose: To report a case of bilateral serous retinal detachment revealing acute myeloblastic leukemia.

Methods: A 31-year-old man presenting with decreased vision in both eyes, 20/50 in the right eye and 20/32 in the left eye, was submitted to a complete ophthalmologic and systemic evaluation.

Results: Fundus biomicroscopy, fluorescein and indocyanine green angiography, and spectral domain optical coherence tomography showed bilateral serous retinal detachment and signs of choroidal ischemia. Enhanced depth imaging spectral domain optical coherence tomography allowed a precise examination of the choroid, by showing an overall thickening of the choroid (749 μm in the right eye and 728 μm in the left eye) and disappearance of the normal hyporeflective visualization of the choroidal vessels. On systemic investigation, the patient was diagnosed with acute myeloblastic leukemia. After systemic chemotherapy, visual acuity improved to 20/20 in both eyes, with resolution of the bilateral serous retinal detachment and choroidal changes.

Conclusion: Bilateral serous retinal detachment may be a presenting sign of acute myeloblastic leukemia. Examination of the choroid using enhanced depth imaging spectral domain optical coherence tomography may suggest the etiology and contribute to early diagnosis and treatment.