Acute leukemia’s ophtalmologic manifestations as first sign of the disease: a case

Abstract

It is believed that 90% of acute leukemia cases affect the eye at some point of the evolution of the disease. Ophtalmologic manifestations can be variable even asymthomatic and, in some cases like the presented one, previous to the diagnosis. A 36 years old woman consults with visual los in the right eye of two days of evolution that started like “little black dots” in her visual field. In the examination we found disminution of visual acuity in the right eye and multiple retinal haemorrages in both eyes. Anemia, hyperleucocitosis and thrombopenia were the results of the blood sample. The patient was then hospitalized by the Hematology Service in our institution, were they arrived to the acute limphoblastyc leukemia diagnosis.

The retina is the most compromised tissue by acute leukemia, being the haemorrages their most frequent manifestation, principaly at the posterior pole. It has been studied the relation between laboratory parameters and ocular findings giving variable results. Ophtalmologic screening at the moment of diagnosis and in the evolution of the disease is of vital importance because ocular findings are relates with worse prognosis.