Ocular manifestations of leukemia: leukemic infiltration versus infectious process.
OBJECTIVE
To determine whether specific guidelines can be developed to distinguish whether retinal infiltration in leukemia patients represents infection or neoplasia.


METHODS
Retrospective noncomparative interventional case series.


METHODS
Six patients recently seen at University of California San Francisco with retinal infiltrates in a setting of leukemia, for which adequate written and photographic information of disease course was available.


METHODS
Observation consisted of retrospective review of clinic charts, hospital medical records, and fundus photographs.


METHODS
Determination of whether retinal infiltrates represented neoplasia or infection was made by review of medical records.


RESULTS
In this series, neoplastic retinal infiltrates were found in patients who had newly diagnosed leukemia and those who were in blast crisis. In contrast, the two patients who were in complete remission, but had undergone bone marrow transplantation, had retinal infiltrates attributable to infection.


CONCLUSIONS
Every patient with retinal infiltrates in the setting of newly or previously diagnosed leukemia requires a systemic and central nervous system workup before the initiation of ophthalmologic treatment. The systemic status of the patient is highly informative in determining whether infection or neoplasia is responsible for the infiltration.
Gordon
K B
KB
Department of Ophthalmology, University of California San Francisco, 10 Koret Way, San Francisco, CA 94143-0730, USA.
Rugo
H S
HS
Duncan
J L
JL
Irvine
A R
AR
Howes
E L
EL
O'Brien
J M
JM
Carter
S R
SR
D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology* / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000473:pathology* / Q000628:therapy; D017254:Leukemic Infiltration / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology* / Q000628:therapy; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis; D012189:Retrospective Studies