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Ophthalmic Images
November 17, 2021

Iris Infiltration From Acute Lymphoblastic Leukemia

Author Affiliations
  • 1Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • 2National Institute of Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital London, United Kingdom
  • 3University College London Institute of Ophthalmology, London, United Kingdom
JAMA Ophthalmol. 2021;139(11):e214054. doi:10.1001/jamaophthalmol.2021.4054

A 42-year-old woman presented with right eye hyperemia. Her medical history included acute lymphoblastic leukemia, from which she was in remission following induction and later maintenance chemotherapy. Examination revealed heterochromia and patchy diffuse iris infiltration, with an amelanotic tumor in the right eye associated with anterior chamber cells and microhyphema (Figure, A). A fine-needle aspiration biopsy of the iris was performed, which confirmed the diagnosis of leukemic iris infiltrates and an isolated ocular relapse of acute lymphoblastic leukemia. The patient was treated with 30-Gy fractionated external-beam radiotherapy to the right eye. The iris nodules and heterochromia resolved with no local recurrence on 8-year follow-up (Figure, B).

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