Al Kalbani Khulood, Al Hinai Ahmed, Al Busaidi Aisha
Ophthalmology Residency Program, Oman Medical Specialty Board, Muscat, Sultanate of Oman.
Department of Ophthalmology, Sultan Qaboos University Hospital, Al Khoudh, Muscat, Oman.
Oman J Ophthalmol. 2022 Nov 2;15(3):356-359. doi: 10.4103/ojo.ojo_93_22. eCollection 2022 Sep-Dec.
A 60-year-old female presented with acute onset painless loss of vision in both eyes. Clinical examination and ocular investigations revealed bilateral serous retinal detachments (SRDs) over the macula. There was no obvious intraocular or extraocular cause to the presentation. A blood count showed leukocytosis with the presence of blast cells on the peripheral smear. Further workup confirmed the diagnosis of Philadelphia chromosome-positive mixed phenotype acute leukemia with central nervous system disease stage three. Anatomic improvement in the SRD followed intensive intravenous and intrathecal chemotherapy. Limited functional improvement was attributed to the development of pigment epitheliopathy manifesting as leopard spot chorioretinopathy. This permanent disturbance could be attributed to leukemic infiltration and ischemia to the choroid.
一名60岁女性出现双眼急性无痛性视力丧失。临床检查和眼科检查发现黄斑区双侧浆液性视网膜脱离（SRD）。该表现无明显眼内或眼外病因。血常规显示白细胞增多，外周血涂片可见原始细胞。进一步检查确诊为费城染色体阳性混合表型急性白血病伴中枢神经系统疾病三期。强化静脉和鞘内化疗后，SRD出现解剖学改善。功能改善有限归因于色素上皮病变的发展，表现为豹纹状脉络膜视网膜病变。这种永久性障碍可能归因于白血病浸润和脉络膜缺血。
