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慢性髓性白血病表现为全葡萄膜炎合并视网膜和脉络膜血管阻塞:一例报告。

A chronic myeloid leukemia presenting as panuveitis combined with retinal and choroidal vascular occlusion: a case report.

机构信息

Department of Ophthalmology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, China.

Department of Hematology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, China.

出版信息

BMC Ophthalmol. 2024 Oct 8;24(1):443. doi: 10.1186/s12886-024-03674-5.

Abstract

BACKGROUND

Chronic myeloid leukemia (CML) can manifest ocular complications stemming from hematologic irregularities or direct infiltration of neoplastic cells. This article details the case of a patient with newly diagnosed CML exhibiting elevated platelet counts (PLT) who developed panuveitis accompanied by retinal vascular occlusion.

CASE PRESENTATION

A 52-year-old woman experienced a notable decline in vision in her left eye over a 2-week period. Classical anterior uveitis, vitreous cavity opacity, optic nerve edema, and retinal vascular obstruction were observed. The right eye exhibited papilledema and retinal vein tortuosity. Despite admission, the condition of both eyes deteriorated, accompanied by a continuous increase in PLT. She was diagnosed with CML based on bone marrow biopsy and chromosomal examination. Following platelet apheresis therapy and chemotherapy, the condition of her right eye significantly improved, but the left eye's condition remained irreversible.

CONCLUSIONS

This is a rare case of newly diagnosed CML presenting with diverse ocular manifestations in both eyes. The disparate outcomes in eyes with varying lesion stages underscore the importance of prompt diagnosis.

摘要

背景

慢性髓细胞白血病(CML)可表现为源于血液学异常或肿瘤细胞直接浸润的眼部并发症。本文详细介绍了一例新诊断为 CML 的患者,其血小板计数(PLT)升高,出现全葡萄膜炎伴视网膜血管阻塞。

病例介绍

一名 52 岁女性,左眼视力在 2 周内显著下降。观察到典型的前葡萄膜炎、玻璃体混浊、视神经水肿和视网膜血管阻塞。右眼出现视盘水肿和视网膜静脉迂曲。尽管住院治疗,但双眼病情恶化,PLT 持续升高。骨髓活检和染色体检查诊断为 CML。血小板分离术治疗和化疗后,右眼病情显著改善,但左眼病情仍不可逆转。

结论

这是一例罕见的新诊断 CML 病例,双眼表现出不同的眼部表现。病变阶段不同的眼睛预后不同,这强调了及时诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26f/11462804/0e46acfaea88/12886_2024_3674_Fig1_HTML.jpg

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