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12 pages, 2258 KB

Open AccessReview

Multifocal Ocular Manifestations Heralding Relapse of Acute Myeloid Leukemia: A Case Report and Literature Review

by Elvia Mastrogiuseppe, Maria Carmela Saturno, Clara Minotti, Martina Angi and Marco Marenco

J. Clin. Med. 2025, 14(21), 7506; https://doi.org/10.3390/jcm14217506 - 23 Oct 2025

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This case-based review examines the spectrum of leukemic ocular involvement, focusing on its prognostic implications. A rare case of relapsed acute myeloid leukemia (AML) in a 63-year-old man is presented, featuring simultaneous orbital proptosis, adnexal involvement, choroidal and retinal infiltration, and hemorrhagic changes affecting both the anterior and posterior segments. This constellation of findings, affecting multiple ocular structures concurrently, highlights the eye’s potential role as a sanctuary site for leukemic cells and underscores the diagnostic challenge of distinguishing direct infiltration from treatment-related or secondary vascular damage. This case, integrated with a literature review, emphasizes that multifocal ocular signs may serve as early indicators of leukemic relapse and reinforce the need for close collaboration between ophthalmologists and hematologists in guiding patient management. Full article

(This article belongs to the Special Issue Ocular Surface, Retina, and Choroid as Mirrors of Systemic and Genetic Diseases)

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7 pages, 1607 KB

Open AccessCase Report

Floaters as the First Manifestation of Chronic Myeloid Leukemia: A Case Report

by Siyun Lee and Joonhyung Kim

Int. J. Mol. Sci. 2025, 26(18), 8841; https://doi.org/10.3390/ijms26188841 - 11 Sep 2025

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Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm arising in hematopoietic stem cells. It may initially present with ocular symptoms, as illustrated by the case of a previously healthy 25-year-old woman who presented with a five-day history of floaters in her left eye. Fundus examination revealed bilateral retinal hemorrhages, Roth spots, increased vascular tortuosity, a left preretinal hemorrhage, and a left vitreous hemorrhage. Retinopathy secondary to a hematologic disorder was considered; the patient was promptly referred to hematology–oncology. Laboratory evaluation demonstrated leukocytosis with anemia, peripheral smear showed 1% myeloblasts, 40% myelocytes, and basophilia. Cytogenetic analysis confirmed t(9;22)(q34;q11.2), and quantitative polymerase chain reaction (PCR) detected a BCR::ABL1 (b3a2) transcript. A diagnosis of bilateral leukemic retinopathy was established, and the patient promptly started appropriate therapy for CML. This case underscores the importance of recognizing ocular findings—such as Roth spots, intraocular hemorrhages, and increased vascular tortuosity—as potential indicators of systemic malignancy and ensuring early referral and management. Early ophthalmic recognition of such findings can be vision- and life-saving. Full article

(This article belongs to the Special Issue Advances in Retinal Diseases: 2nd Edition)

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11 pages, 3094 KB

Open AccessEditor’s ChoiceReview

Ophthalmic Manifestations in Patients with Blood Malignancies

by Costanza Rossi, Alessandro Buizza, Giuseppe Alessio, Massimiliano Borselli, Andrea Taloni, Adriano Carnevali, Giovanna Carnovale Scalzo, Andrea Lucisano, Vincenzo Scorcia and Giuseppe Giannaccare

Hematol. Rep. 2024, 16(2), 193-203; https://doi.org/10.3390/hematolrep16020020 - 28 Mar 2024

Cited by 3 | Viewed by 2651

Abstract

Ocular complications can occur in up to 90% of patients with blood malignancies. Such complications range from direct infiltration to local hemostatic imbalance and treatment-related toxicity. This narrative review is based on a systematic computerized search of the literature conducted until January 2024 and examines the common ocular complications associated with blood cancers. Ocular complications from primary disease include mass effects from ocular adnexal lymphomas and intraocular lymphomas, with B-cell lymphomas accounting for 95% of primary ocular presentations. Secondary disease involvement from systemic hematological malignancies can lead to a wide range of ocular manifestations, such as leukemic retinopathy. Furthermore, toxicity from antineoplastic therapies and ocular graft versus host disease (oGVHD) after hematopoietic stem cell transplantation present additional risks to ocular health. In conclusion, ocular complications in blood cancer patients are an integral part of patient management, requiring regular ophthalmic evaluations and close collaboration between oncologists and ophthalmologists. Advances in therapy and an increased focus on early symptom recognition are essential for preserving vision and enhancing patient quality of life. Full article

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4 pages, 497 KB

Open AccessArticle

Concurrent Hypopituitarism and Leukemic Retinopathy in a Child with B-Precursor Acute Lymphoblastic Leukemia and Isolated Central Nervous System Relapse

by K.H. Wu, H.P. Wu, H.J. Lin, C.H. Wang, H.Y. Chen, T. Weng, C.T. Peng and Y.H. Chao

Curr. Oncol. 2016, 23(4), 431-434; https://doi.org/10.3747/co.23.3006 - 1 Aug 2016

Viewed by 809

Abstract

Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of B-precursor all without cns involvement. Three months after chemotherapy completion, she presented with lower-extremity weakness and was diagnosed with an isolated cns relapse. Concurrent hypopituitarism and leukemic retinopathy were also found. After receiving craniospinal radiotherapy and systemic chemotherapy, her retinopathy and vision improved. She is now in complete remission, and she is still on chemotherapy according to the guideline from the Pediatric Oncology Group. Although rare, hypopituitarism and leukemic retinopathy should be taken into consideration in patients with cns involvement by leukemia. Full article

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