title: Bilateral proliferative retinopathy as the initial presentation of chronic myeloid leukemia.
abstract: The authors report a rare case of a 48-year-old male with chronic myeloid leukemia (CML) who initially presented with a bilateral proliferative retinopathy. The patient complained of recent visual loss and floaters in both eyes (BE). Ophthalmologic evaluation revealed a best corrected visual acuity (BCVA) of 20/50 in the right eye and 20/200 in the left eye (LE). Fundoscopy showed the presence of bilateral peripheral capillary dropout with multiple retinal sea fan neovascularisations, which were confirmed on fluorescein angiography. Full blood count revealed hyperleukocytosis, thrombocytosis, anemia, and hyperuricemia. Bone marrow aspiration and biopsy showed the reciprocal chromosomal translocation t (9;22), diagnostic of CML. The patient was started on hydroxyurea, allopurinol and imatinib mesylate. He received bilateral panretinal laser photocoagulation and a vitrectomy was performed in the LE. The patient has been in complete hematologic, cytogenetic, and major molecular remission while on imatinib and his BCVA is 20/25 in BE.
authors: Department of Ophthalmology, Hospital de Santo António-Centro Hospitalar do Porto, Portugal.
authors: Mafalda S F
authors: MS
authors: Macedo
authors: Ana R M
authors: AR
authors: Figueiredo
authors: Natália N
authors: NN
authors: Ferreira
authors: Irene M A
authors: IM
authors: Barbosa
authors: Maria João F B S
authors: MJ
authors: Furtado
authors: Nuno F C B A
authors: NF
authors: Correia
authors: Miguel P
authors: MP
authors: Gomes
authors: Miguel R B
authors: MR
authors: Lume
authors: Maria João S
authors: MJ
authors: Menéres
authors: Marinho M N
authors: MM
authors: Santos
authors: M Angelina C S
authors: MA
authors: Meireles
mesh_terms: D000493:Allopurinol / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001549:Benzamides / Q000008:administration & dosage; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics; D002899:Chromosomes, Human, Pair 9 / Q000235:genetics; D003131:Combined Modality Therapy; D005451:Fluorescein Angiography; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D000068877:Imatinib Mesylate; D017075:Laser Coagulation; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage; D011743:Pyrimidines / Q000008:administration & dosage; D015861:Retinal Neovascularization / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D014178:Translocation, Genetic / Q000235:genetics; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000493:Allopurinol; D000068877:Imatinib Mesylate; D006918:Hydroxyurea
keywords: Chronic Myeloid Leukemia; Hyperviscosity Syndrome; Proliferative Retinopathy