All-trans retinoic Acid differentiation syndrome chorioretinopathy: a case of multifocal serous neurosensory detachments in a patient with acute promyelocytic leukemia treated with all-trans retinoic Acid.
OBJECTIVE
The purpose of this study was to report a case of multifocal serous neurosensory retinal detachments associated with systemic differentiation syndrome (DS) (formerly known as all-trans retinoic acid [ATRA] syndrome) in a patient with acute promyelocytic leukemia.


METHODS
In this observational case report, we identify a case of DS because of ATRA induction therapy with associated multiple focal serous neurosensory retinal detachments in a 39-year-old man with acute promyelocytic leukemia.


RESULTS
While suffering from a rebound episode of DS secondary to ATRA therapy, the patient experienced deterioration of his vision bilaterally. Within 8 days of discontinuing ATRA and the initiation of dexamethasone, the patient's systemic status and ocular findings resolved completely. Optical coherence tomography and fluorescein angiography confirmed the resolution of the subretinal fluid.


CONCLUSIONS
Given the time of onset of the patient's visual symptoms with associated chorioretinopathy, his concurrent systemic manifestations of DS, along with his concurrent systemic, and ocular response to treatment, we speculate that this is the first reported occurrence of ATRA-associated chorioretinopathy in a patient with ATRA DS.
*Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, Canada †Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, Canada ‡Department of Medicine, Maharaj nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand.
Steve D
SD
Levasseur
Adisak
A
Tantiworawik
David A
DA
Lambert Maberley