|Year : 2022 | Volume
| Issue : 4 | Page : 288
Unilateral vision loss unmasking underlying acute leukemia
Pradeep Kumar Panigrahi
Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
|Date of Submission||10-Nov-2021|
|Date of Decision||01-Jan-2022|
|Date of Acceptance||09-Jan-2022|
|Date of Web Publication||18-Oct-2022|
Dr. Pradeep Kumar Panigrahi
Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan (Deemed to be University), 8-Kalinga Nagar, Bhubaneswar - 751 003, Odisha
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Panigrahi PK. Unilateral vision loss unmasking underlying acute leukemia. J Appl Hematol 2022;13:288
A 19-year-old healthy male presented with sudden onset loss of vision in the left eye (LE) of 1-week duration. The patient gave a history of fever, weight loss, and anorexia for the past 1 month. Visual acuity was 6/6 and 1/60 in the right eye (RE) and LE, respectively. Fundus examination of RE was unremarkable. Fundus examination of LE showed plenty of white-centered retinal hemorrhages (Roth's spots) (white arrows) with premacular hemorrhage (yellow arrow) [Figure 1]. Blood investigations showed leukocytosis (30,000/μL), anemia (Hb-9.6 gm%), and thrombocytopenia (70,000/μL). Further hematological investigations led to a diagnosis of B-cell acute lymphoblastic leukemia. Retinopathy can be the initial manifestation of acute leukemia. Presentation is usually bilateral and clinical findings include vascular tortuosity, Roth spots, multi-layered retinal hemorrhages, retinal neovascularization, vitreous hemorrhage, leukemic ad infiltarion. Unilateral retinopathy leading to a diagnosis of acute leukemia is very rare. White-centered retinal hemorrhages in an otherwise healthy patient should lead to a suspicion of hematological disorders. Appropriate investigations will help in arriving at the correct diagnosis.
|Figure 1: Colour fundus photograph of left eye showing multiple white centred haemorrhages (white arrows) and pre macular haemorrhage (yellow arrow)|
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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