Korean J Ophthalmol.  2010 Aug;24(4):245-248. 10.3341/kjo.2010.24.4.245.

Bilateral Serous Retinal Detachment as a Presenting Sign of Acute Lymphoblastic Leukemia

• Kim J
• Chang W
• Sagong M

• KMID: 949064
• DOI: http://doi.org/10.3341/kjo.2010.24.4.245

Abstract

We present a case of bilateral serous retinal detachment (SRD) as a presenting sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). A 45-year-old woman presented with decreased vision and was found to have bilateral serous retinal detachment. Peripheral blood smears revealed leukocytosis of 53.9x10(3)/microliter with 64.6% lymphoblasts. A bone marrow aspirate revealed the presence of lymphoblasts. Cytogenetic and molecular genetic analysis detected a reciprocal translocation between chromosome 9 and 22, t(9;22) (q34;q11). A diagnosis of Ph+ ALL was made. Following systemic chemotherapy, the bilateral SRD resolved completely with full recovery of vision. The sudden appearance of SRD should raise suspicion for leukemia. Prompt recognition of this disease is important for early systemic treatment and restoration of visual function.

Keyword

Acute lymphoblastic leukemia; Precursor cell lymphoblastic leukemia-lymphoma; Serous retinal detachment

MeSH Terms

Antineoplastic Agents/therapeutic use
Female
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Humans
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications/diagnosis/drug therapy
Recovery of Function
Retinal Detachment/diagnosis/*etiology/physiopathology
Tomography, Optical Coherence
Visual Acuity/physiology

Figure

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  Fig. 1 (A) Fundus photographs of the right eye (left) and left eye (right) showing bilateral serous retinal detachment in the macula at the initial visit. (B) Corresponding fluorescein angiograms show diffuse subretinal accumulation of fluorescein with multifocal hyper-fluorescent dots. (C) Corresponding optical coherence tomography scans show serous macular detachment.

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  Fig. 2 (A) Fundus photographs of the right eye (left) and left eye (right) showing complete resolution of bilateral serous retinal detachment one month after systemic chemotherapy. (B) Corresponding fluorescein angiograms show no subretinal accumulation of fluorescein. (C) Corresponding optical coherence tomography scans show nearly normal foveal anatomy.

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