title: Acute lymphoblastic leukemia presenting with bilateral serous macular detachment.
abstract: Acute lymphoblastic leukemia is a malignant hematopoietic neoplasia, which is rare in adults. Although ocular fundus alterations may be commonly observed in the course of the disease, such alterations are rarely the presenting signs of the disease. Here we describe the case of a patient with painless and progressive loss of visual acuity (right eye, 2/10; left eye, 3/10) developing over two weeks, accompanied by fever and cervical lymphadenopathy. Fundus examination showed bilateral macular serous detachment, which was confirmed by optical coherence tomography. Fluorescein angiography revealed hyperfluorescent pinpoints in the posterior poles. The limits of the macular detachment were revealed in the late phase of the angiogram. The results of blood count analysis triggered a thorough, systematic patient examination. The diagnosis of acute lymphoblastic leukemia B (CD10+) was established, and intensive systemic chemotherapy was immediately initiated. One year after the diagnosis, the patient remains in complete remission without any ophthalmologic alterations.
authors.affiliation: Central Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: Luisa
authors.initials: L
authors.lastname: Vieira
authors.affiliation: Central Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: Nuno Aguiar
authors.initials: NA
authors.lastname: Silva
authors.affiliation: Central Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: Marco Dutra
authors.initials: MD
authors.lastname: Medeiros
authors.affiliation: Central Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Flores
authors.affiliation: Central Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: Vitor
authors.initials: V
authors.lastname: Maduro
mesh_terms: D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012163:Retinal Detachment / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity