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Photo Essay
April 1, 2005

Chronic Myelogenous Leukemia Manifested as Bilateral Proliferative Retinopathy

Arch Ophthalmol. 2005;123(4):576. doi:10.1001/archopht.123.4.576

A 27-year-old previously healthy man was seen with bilateral floaters, fatigue, and early satiety. His visual acuity was 20/80 OD and 20/70 OS. A clinical examination (Figure 1 and Figure 2) and fluorescein angiography (Figure 3) were performed. Laboratory analysis revealed a white blood cell count of 3.22 × 105/μL, with 12% bands, 14% metamyelocytes, 23% myelocytes, and 9% myeloblasts. Serum glucose and glycosylated hemoglobin levels were within normal limits. There was no evidence of hemoglobinopathy by electrophoresis. A bone marrow biopsy demonstrated the bcr-abl translocation (Figure 4). Chronic myelogenous leukemia was diagnosed, and the patient was given hydroxyurea, allopurinol, and imatinib mesylate (Gleevec). Ophthalmic treatment included panretinal photocoagulation and vitrectomy.