A 25-Year-Old Man with Exudative Retinal Detachments and Infiltrates without Hematological or Neurological Findings Found to Have Relapsed Precursor T-Cell Acute Lymphoblastic Leukemia.
BACKGROUND
Precursor T-cell acute lymphoblastic leukemia (pre-T-ALL) may cause ocular pathologies such as cotton-wool spots, retinal hemorrhage, and less commonly, retinal detachment or leukemic infiltration of the retina itself. However, these findings are typically accompanied by the pathognomonic hematological signs of acute leukemia.


METHODS
In this case report and review of the literature, we describe a particularly unusual case of a 25-year-old man who presented to our hospital with bilateral exudative retinal detachments associated with posterior pole thickening without any hematological or neurological findings. The patient, who had a history of previously treated pre-T-ALL in complete remission, was found to have leukemia cell infiltration on retinal biopsy.


CONCLUSIONS
Our case underscores the fact that the ophthalmologist may be the first provider to detect the relapse of previously treated leukemia, and that ophthalmic evaluation is critical for detecting malignant ocular infiltrates.
Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, La, Boston, Mass., USA.
Jordan S
JS
Johnson
Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, La, Boston, Mass., USA.
James S
JS
Lopez
Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, La, Boston, Mass., USA.
Arthur Scott
AS
Kavanaugh
Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, La, Boston, Mass., USA.
Chanping
C
Liang
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA.
Douglas A
DA
Mata
Leukemia; Ophthalmology; Retinal detachment