Jamshidi Farzad, Boyce Timothy M, Christopher Bowen R, Culver Boldt H, Binkley Elaine M
Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA.
Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
Am J Ophthalmol Case Rep. 2025 Aug 31;39:102417. doi: 10.1016/j.ajoc.2025.102417. eCollection 2025 Sep.
To present a case of severe leukemic retinopathy requiring surgical rehabilitation. We report four-year follow up and associated post-remission pathology including cystoid macular edema (CME) and retinal ischemia.
This is a case report of a 35-year-old female with acute myelocytic leukemia (AML) who presented with hand motions (HM) vision in both eyes and severe multilayered hemorrhages. She underwent pars plana vitrectomy (PPV) in the left eye and subsequent PPV with internal limiting membrane (ILM) peel in the right eye after autologous bone marrow transplant. After cataract surgery and treatment of CME, visual acuity improved to 20/25 in each eye. Fundus examination and optical coherence tomography (OCT) revealed outer retinal loss outside of the fovea.
Surgical intervention can be necessary for visual rehabilitation in some patients with leukemic retinopathy. With improved medical treatment for AML, patients survive longer, making visual rehabilitation more impactful and allowing for a better understanding of the natural history of leukemic retinopathy.
介绍一例需要手术康复的严重白血病性视网膜病变病例。我们报告了四年的随访情况以及缓解期后的相关病理学表现，包括黄斑囊样水肿（CME）和视网膜缺血。
这是一例35岁急性髓细胞白血病（AML）女性患者的病例报告，患者双眼视力仅存手动（HM），并伴有严重的多层出血。她在自体骨髓移植后，左眼接受了玻璃体切割术（PPV），右眼随后接受了PPV联合内界膜（ILM）剥除术。白内障手术及CME治疗后，双眼视力均提高到20/25。眼底检查和光学相干断层扫描（OCT）显示黄斑中心凹以外的视网膜外层缺失。
对于一些白血病性视网膜病变患者，手术干预可能是视觉康复所必需的。随着AML医疗水平的提高，患者生存期延长，使视觉康复更具意义，并有助于更好地了解白血病性视网膜病变的自然病程。
