Chronic Myeloid Leukemia Coverage from Every Angle

Rare Case of Unilateral CML Retinopathy Reported

By: Joseph Fanelli
Posted: Monday, April 29, 2019

Published in the American Journal of Ophthalmology Case Reports is reportedly the first account of unilateral leukemic retinopathy secondary to low-risk chronic myeloid leukemia (CML). The case illustrates the need for CML to be included in the differential diagnosis of patients with progressive monocular vision loss with suspicious multilayer retinal compromise, concluded Mark P. Seraly, MD, of the West Virginia University School of Medicine, and colleagues.

“Further investigation is required to elucidate the connection between CML ocular manifestations, visual prognosis, and disease risk stratification,” the authors observed.

The case presents the diagnosis of a 63-year-old woman who was referred to the West Virginia University Eye Institute after 1 month of progressive vision loss in her right eye; it featured dark reticular curtain-like floaters. The patient’s visual acuity was 20/200 in the right eye after several months of progressive monocular vision loss, and she was found to have dense preretinal hemorrhage. The patient underwent 23-gauge pars plana vitrectomy to clear the preretinal tear and multilayer retinal hemorrhage.

Subsequently, when it was discovered that the patient tested positive for the fusion protein of breakpoint cluster gene with BCR-ABL1 upon systemic workup, she was diagnosed with CML. Imatinib therapy resulted in complete hematologic and cytogenetic resolution after 1 month, although the patient’s vision remained unchanged 6 months after surgery.

“This case demonstrates that despite appropriate medical and surgical management, ocular improvement may not always be feasible given the duration and extent of retinal damage in eyes affected by CML retinopathy.”

Disclosure: The study authors reported no conflicts of interest.

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