Combined orbital proptosis and exudative retinal detachment as initial manifestations of acute myeloid leukemia.
We report bilateral orbital and choroidal involvement as the presenting sign of acute myeloid leukemia in a 2-year-old white girl. The patient presented with painless proptosis and subconjunctival hemorrhage. Ophthalmic examination and magnetic resonance imaging revealed bilateral leukemic infiltrates of the orbits and choroid, with an exudative retinal detachment in the right eye. Bone marrow biopsy confirmed acute myeloid leukemia. Following radiation treatment, chemotherapy, and hematopoietic stem cell transplantation, the patient was doing well 12 months after presentation. Outcomes can be poor, even with treatment; prompt recognition of ophthalmic manifestations of leukemia, including proptosis, choroidal infiltration, and retinal detachment, is necessary.
Department of Ophthalmology, University of Florida, College of Medicine, Jacksonville, Florida.
Wassia A
WA
Khaja
Division of Pediatric Ophthalmology, Nemours Children's Clinic, Jacksonville, Florida. Electronic address: alexander.pogrebniak@ecof.com.
Alexander E
AE
Pogrebniak
Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida.
James P
JP
Bolling
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D005094:Exophthalmos / Q000175:diagnosis* / Q000628:therapy; D005122:Exudates and Transudates; D005260:Female; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D033401:Microscopy, Acoustic; D064847:Multimodal Imaging; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000628:therapy; D011878:Radiotherapy; D012163:Retinal Detachment / Q000175:diagnosis* / Q000628:therapy
D000970:Antineoplastic Agents