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双侧视力丧失作为一名年轻成年人慢性髓性白血病的初始表现:一例病例报告及文献复习

Bilateral vision loss as initial presentation of chronic myeloid leukemia in a young adult: A case report and review of the literature.

作者信息

Brown Nathan J, Kaya Erin A, Haymore Jonathan G, Gioia Lauren V

机构信息

Elson S. Floyd College of Medicine, Washington State University, 412 E Spokane Falls Blvd, Spokane, WA, USA.

MultiCare Rockwood Clinic Eye and Optical Center, 400 E 5th Ave, Spokane, WA, USA.

出版信息

Am J Ophthalmol Case Rep. 2022 May 9;26:101579. doi: 10.1016/j.ajoc.2022.101579. eCollection 2022 Jun.

Abstract

PURPOSE

To report a case of bilateral vision loss as the primary presenting symptom of chronic myeloid leukemia in a young adult.

OBSERVATIONS

The 28-year-old male patient presented to clinic with visual acuity of 20/200 in both eyes after several months of episodic bilateral vision loss. Intraretinal and pre-retinal hemorrhages were appreciated, as well as Roth spots and peripheral neovascularization. Initial lab findings were consistent with a diagnosis of acute myeloid leukemia, later, upon bone marrow examination, the diagnosis was edited to chronic myeloid leukemia. Dasatinib therapy resulted in a complete hematologic resolution after six weeks. After intravitreal injections of bevacizumab in both eyes, visual acuity improved to 20/25 in the right eye and 20/20 in the left eye.

CONCLUSION AND IMPORTANCE

After review, this is one of only a few reported cases of bilateral blurry vision as the primary presenting symptom of chronic myeloid leukemia in a young adult. Because visual disturbances occur more frequently in acute myeloid leukemia, and lab results may be inconclusive, careful consideration should be given to differentiate myelogenous leukemias, as the acute and chronic subtypes may present similarly.

摘要

目的

报告一例以双侧视力丧失为主要表现症状的青年慢性髓性白血病病例。

观察结果

这位28岁男性患者在经历数月发作性双侧视力丧失后就诊时,双眼视力为20/200。可见视网膜内和视网膜前出血,以及Roth斑和周边新生血管形成。最初的实验室检查结果与急性髓性白血病的诊断相符,后来经骨髓检查,诊断修正为慢性髓性白血病。达沙替尼治疗六周后实现了完全血液学缓解。双眼玻璃体内注射贝伐单抗后,右眼视力提高到20/25,左眼视力提高到20/20。

结论与意义

经查阅,这是少数几例报告的以双侧视力模糊为青年慢性髓性白血病主要表现症状的病例之一。由于视力障碍在急性髓性白血病中更常见,且实验室检查结果可能不明确,因此应仔细考虑区分髓系白血病,因为急性和慢性亚型可能表现相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1722/9114453/eaacab63824e/gr1.jpg

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A unique case of chronic myeloid leukemia presenting as monocular vision loss with unilateral retinopathy.
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