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ACUTE VISION LOSS AS THE ONLY SIGN OF LEUKEMIA RELAPSE

Cerdà-Ibáñez, Marta, MD*; Bayo-Calduch, Patricia, MD, PhD, FEBO*; Manfreda-Domínguez, Laura, MD, PhD*; Duch-Samper, Antonio, MD, PhD, FEBO*,†

Retinal Cases and Brief Reports: January 2018 - Volume 12 - Issue 1 - p 10–11
doi: 10.1097/ICB.0000000000000378
Case Report
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Purpose: To report a case of unilateral exudative retinal detachment as the sole presentation of relapsing B-type lymphoblastic leukemia in a 35-year-old man after 3 years of remission.

Methods: Case report.

Results: A 35-year-old man in complete remission of high-risk type B acute lymphoblastic leukemia (ALL-B) presented with acute vision loss in his left eye. Exudative retinal detachment was diagnosed at initial evaluation. Hematological and ocular studies were performed. Although there was no evidence of blood, cerebrospinal fluid, or bone marrow disease relapse, transvitreal retinochoroidal cytology identified the infiltration of lymphoblastic leukemic B cells with t(12:21) translocation as the only sign of relapsing ALL-B.

Conclusion: At first sign of vision loss or ocular symptoms in a patient with a history of lymphoblastic leukemia, and regardless of the hematological findings, exhaustive ophthalmologic exploration and ocular biopsy should be performed without delay—this being crucial for clinical decision making because a prompt diagnosis improves the chances of survival.

Exudative retinal detachment can be the only sign of lymphoproliferative disorder relapse and an early manifestation of such relapse. A prompt diagnosis therefore implies higher survival rates.

*Department of Ophthalmology, Valencia University Clinic Hospital, Valencia, Spain; and

Department of Medicine, University of Valencia, Spain.

Reprint requests: Marta Cerdà-Ibáñez, MD, C/Jaime Esteve Cubells, 1-29, 46020 Valencia, Spain; e-mail: mcerdaib@gmail.com

None of the authors have any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.