title: Chronic Myeloid Leukaemia Presenting as Bilateral Retinal Haemorrhages with Multiple Retinal Infiltrates.
abstract: Chronic Myeloid Leukaemia (CML) causes retinopathy manifesting as venous dilation and tortuosity, perivascular sheathing, retinal haemorrhages, microaneurysms, cotton-wool spots and optic nerve infiltration. Retina is the most commonly involved intraocular structure in CML. However, retinal involvement is a rare form of presentation of CML and few cases have been reported. We report a case of CML presenting as unilateral sudden visual loss. Fundus showed multiple white centered retinal haemorrhages in both eyes with unilateral macular oedema. Blood work-up showed raised WBC count, high platelet count and low Haemoglobin. Cytological analysis of bone marrow biopsy confirmed Philadelphia chromosome. After a course of Imatinib, visual acuity improved and haemorrhages resolved with normalization of macular thickness. In our case, patient presented early, leading to early detection producing better visual prognosis. This highlights the importance of detailed hematological work up in patients with retinal involvement to rule out leukaemic retinopathy.
authors.affiliation: Registrar, Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Hospital , Kalwa, India .
authors.forename: Priyanka Ramkrishna
authors.initials: PR
authors.lastname: Rane
authors.affiliation: Associate Professor and Head of Department, Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Hospital , Kalwa, India .
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Barot
authors.affiliation: Professor and Head of Department, Department of Ophthalmology, Shri M.P. Shah Government College and Guru Gobind Singh Hospital , Jamnagar, India .
authors.forename: Devadatta Jayantilal
authors.initials: DJ
authors.lastname: Gohel
authors.affiliation: Registrar, Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Hospital , Kalwa, India .
authors.forename: Nupur
authors.initials: N
authors.lastname: Bhagat
keywords: Imatinib; Leukaemic infiltration; Macular oedema