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Ophthalmic Images
March 12, 2020

Fundus Abnormalities in Acute Leukemia

Author Affiliations
  • 1Department of Ophthalmology, Universitary Hospital of Geneva, Geneva, Switzerland
JAMA Ophthalmol. 2020;138(3):e190934. doi:10.1001/jamaophthalmol.2019.0934

We report a case of a 13-year-old boy experiencing a medullar and meningeal relapse of T-cell acute lymphocytic leukemia. The patient presented with complaints of decreased visual acuity in both eyes. The anterior segment findings were normal, but the fundus examination revealed optic nerve swelling, focal active white choroidal and subretinal infiltrations, and areas of hyperpigmented lesions in the periphery of both eyes. The workup eliminated any viral, bacterial, or mycotic infection as a cause, and chemotherapy treatment was continued as scheduled. One month later, an examination revealed decreased papillary edema, and the active white lesions were replaced by cicatricial hyperpigmented lesions in a leopard-spot pattern.