Chew Bonilla Alan, Bueno Zarazúa Paulina, Rosales Padron Jaime, Fulda Graue Emiliano, Graue Wiechers Federico
Retina Department, Institute of Ophthalmology Fundación Conde de Valenciana, Chimalpopoca 14, Colonia Obrera, Mexico City, 06800, Mexico.
Am J Ophthalmol Case Rep. 2024 Jul 25;36:102132. doi: 10.1016/j.ajoc.2024.102132. eCollection 2024 Dec.
This report highlights a rare case of delayed manifestation of proliferative retinopathy associated with chronic myeloid leukemia (CML) during remission.
Case report and review of the literature; In this case report, we outline the delayed manifestation and clinical progression of proliferative retinopathy in a 52-year-old male patient with a history of CML diagnosed in 2001. Initially, the patient presented with a white blood cell count (WBC) of 402,200/μl, and the leukocytosis persisted until 2005. Thereafter, the patient remained in remission for over 15 years without any visual complaints until 2022. At that time, the patient sought medical attention due to a ten-day history of left eye visual impairment, leading to the discovery of peripheral neovascularization in both eyes and vitreous hemorrhage in the left eye during fundus examination. The WBC count at the time of presentation to the Emergency Department was 10,460/μl. The patient was treated with fluorescein angiography guided panretinal photocoagulation to the areas of ischemic retina. Subsequent follow-up after eight months demonstrated regression of neovascularization.
Our findings highlight the occurrence of proliferative retinopathy in the context of CML, uniquely manifesting during remission. This case emphasizes the importance of ophthalmological assessments not only at the time of CML diagnosis but also during subsequent follow-ups, recognizing the potential for delayed presentation of ocular complications.
本报告重点介绍了1例慢性髓系白血病（CML）缓解期增殖性视网膜病变延迟表现的罕见病例。
病例报告及文献复习；在本病例报告中，我们概述了1例2001年诊断为CML的52岁男性患者增殖性视网膜病变的延迟表现及临床进展。最初，患者白细胞计数（WBC）为402,200/μl，白细胞增多持续至2005年。此后，患者缓解超过15年，直至2022年一直无任何视觉主诉。当时，患者因左眼视力损害10天就诊，眼底检查发现双眼周边新生血管形成及左眼玻璃体积血。就诊于急诊科时的WBC计数为10,460/μl。患者接受了荧光素血管造影引导下对缺血视网膜区域进行的全视网膜光凝治疗。8个月后的后续随访显示新生血管消退。
我们的研究结果突出了CML背景下增殖性视网膜病变的发生，其独特之处在于在缓解期出现。该病例强调了眼科评估的重要性，不仅在CML诊断时，而且在后续随访中，认识到眼部并发症延迟出现的可能性。
