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Sudden unilateral visual loss as an initial presentation of chronic myelogenous leukemia

DOI: http://dx.doi.org/10.2147/OPTO.S9449

Keywords: chronic myelogenous leukemia, retinal hemorrhages, Roth spot, imatinib (Gleevec ) Philadelphia chromosome, vision loss

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Abstract:

dden unilateral visual loss as an initial presentation of chronic myelogenous leukemia Other (4238) Total Article Views Authors: Len V Hua, Salisa K Williams Published Date March 2010 Volume 2010:2 Pages 29 - 35 DOI: http://dx.doi.org/10.2147/OPTO.S9449 Len V Hua, Salisa K Williams Pacific University Eye Clinic, Forest Grove, OR, USA Abstract: Leukemia is a cancer of the white blood cells. Many patients with leukemia are unaware of their disease until routine blood work up for other conditions reveals incidental findings leading to a diagnosis of leukemia. Up to 50% of patients with leukemia have ocular manifestations. In fact, floaters or decreased vision may be the initial symptom of leukemia. Case study: A 51-year-old Caucasian female patient with sudden unilateral visual loss in the left eye was found to have bilateral retinal neovascularization and Roth spot hemorrhages. Blood work up and cytological analyses confirmed the Philadelphia chromosome, which has been implicated in the development of chronic myelogenous leukemia (CML). Further testing confirmed a diagnosis of chronic phase CML. After a two-month course of imatinib and close monitoring by a hematological oncologist, her vision has improved and the retinal vascularization has significantly resolved. Conclusions: Eye care professionals are in a unique position to identify this devastating disease early on. A delay in diagnosis of the disease may lead to conversion into the acute phase, which has a poor prognosis for survival. A prompt referral to internal medicine and oncology for co-management is crucial.

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