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Case Reports
. 2016 May;10(5):ND04-5.
doi: 10.7860/JCDR/2016/18215.7822. Epub 2016 May 1.

Chronic Myeloid Leukaemia Presenting as Bilateral Retinal Haemorrhages with Multiple Retinal Infiltrates

Priyanka Ramkrishna Rane  1 , Rakesh K Barot  2 , Devadatta Jayantilal Gohel  3 , Nupur Bhagat  1
Affiliations
Case Reports

Chronic Myeloid Leukaemia Presenting as Bilateral Retinal Haemorrhages with Multiple Retinal Infiltrates

Priyanka Ramkrishna Rane et al. J Clin Diagn Res. 2016 May.

Abstract

Chronic Myeloid Leukaemia (CML) causes retinopathy manifesting as venous dilation and tortuosity, perivascular sheathing, retinal haemorrhages, microaneurysms, cotton-wool spots and optic nerve infiltration. Retina is the most commonly involved intraocular structure in CML. However, retinal involvement is a rare form of presentation of CML and few cases have been reported. We report a case of CML presenting as unilateral sudden visual loss. Fundus showed multiple white centered retinal haemorrhages in both eyes with unilateral macular oedema. Blood work-up showed raised WBC count, high platelet count and low Haemoglobin. Cytological analysis of bone marrow biopsy confirmed Philadelphia chromosome. After a course of Imatinib, visual acuity improved and haemorrhages resolved with normalization of macular thickness. In our case, patient presented early, leading to early detection producing better visual prognosis. This highlights the importance of detailed hematological work up in patients with retinal involvement to rule out leukaemic retinopathy.

Keywords: Imatinib; Leukaemic infiltration; Macular oedema.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
RE fundus photograph showing white-centered haemorrhages (leukaemic infiltrations) and segmental perivascular white infiltrates.
[Table/Fig-2]:
[Table/Fig-2]:
LE fundus photograph showing multiple pre-retinal haemorrhages and white-centered haemorrhages with macular oedema.
[Table/Fig-3]:
[Table/Fig-3]:
Ocular coherence tomography evaluation of LE shows macular oedema.
See this image and copyright information in PMC

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