Bilateral Retinal Infiltration and Ischemia as the First Presenting Sign of Chronic Myeloid Leukemia: A Case Report with Multimodal Imaging

双侧视网膜浸润和缺血作为慢性粒细胞白血病的首发症状:一例多模态影像学病例报告

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Abstract

Chronic myeloid leukemia (CML) is a malignant proliferative disorder involving the bone marrow and lymphatic system. Retinal involvement is a rare form of presentation in patients with CML. We report a case of a 49-year-old woman who presented with an acute bilateral visual disturbance. Her initial visual acuity was 20/20 in both eyes. Fundus examination revealed multiple yellowish retinal infiltrates, vascular sheathing, and peripheral sclerosed blood vessels. Fundus fluorescein angiography revealed bilateral peripheral retinal ischemia. Optical coherence tomography of the macula showed varying sizes of hyperreflective lesions distributed within the inner and outer retinal layers and in the subretinal space. Systemic workup revealed marked leukocytosis, and bone marrow biopsy revealed CML. Patients with CML can rarely present with ocular symptoms. Early recognition and prompt referral are crucial in lifesaving.

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