Recurrence of acute lymphoblastic leukemia manifesting as serous retinal detachments and optic disc swelling

Abstract

Serous retinal detachment and optic disc swelling are unusual ocular manifestations of ALL. They may occur due to leukemic infiltration of ocular structures and may indicate extramedullary recurrence of the disease. Early recognition and treatment is crucial to improve prognosis.

Proliferative Leukemic Retinopathy With Bilateral Exudative Retinal Detachments and Optic Disc Swelling in a Patient With Acute Lymphoblastic Leukemia

“…The most common site of ophthalmic involvement is the retina. 4,[8][9][10] Common retinal manifestations of ALL include venous dilatation and tortuosity, white centered retinal hemorrhages and cotton wool spots. 10 Serous retinal detachment and optic disc swelling are less common.…”

“…10 Serous retinal detachment and optic disc swelling are less common. 4,10 Proliferative retinopaty in acute leukemia has also been rarely report. Only three case reports in literature where acute lymphoblastic leukemia patients had proliferative retinopathy.…”

“…All parts of the eye including retina, optic nerve, and choroid can be effected.1 While microvascular changes, intraretinal and vitreous hemmorrhage and leukemic infiltrates are commonly seen, exudative retinal detachment is a less common. 2,3,4 Proliferative retinopathy occurs due to chronic nonperfusion of a large areas of the retina that predisposes to retinal neovascularization, and in acute leukemias has been rarely report. Only three case reports in literature where acute lymphoblastic leukemia (ALL) patients had proliferative retinopathy.…”

Acute lymphoblastic leukemia relapse presenting as retinal vasculitis

“…Retinal manifestations such as serous retinal detachment revealing a relapse of ALL are uncommon. 3,4 Although only few cases described optic nerve involvement in a relapse of acute lymphoblastic leukemia, none have described concomitant normal MRI of the orbits and cerebrospinal fluid analysis. 1,10 Our case shows that isolated ocular involvement in the form of retinal vasculitis progressing to infiltrative optic neuropathy may precede by weeks or months the confirmation of ALL relapse with CNS infiltration.…”

“…1,2 Ocular manifestations can occur during either acute phase of the disease or relapse phase. 3 We herein describe a patient who presented with retinal vasculitis as the initial manifestation of acute lymphoblastic leukemia relapse.…”