CHALLENGING CASES OF BILATERAL RETINAL INFILTRATION IN PATIENT WITH RELAPS ACUTE LYMPHOBLASTIC LEUKEMIA: A CASE REPORT
Author: Anindita Wicitra
Base Hospital / Institution: Dharmais National Cancer Center
ePoster presentation
Abstract ID: 24-443
Purpose
Leukemia is a malignant neoplasm of bone marrow that can impact multiple organs of the body including the eyes. Ocular infiltration may disappear after starting the treatment of systemic leukemia or can occur during the recurrence of the disease. Leukemic cells can infiltrate all orbital structures, with choroid becoming the most commonly infiltrated anatomic location. This study aims to describe a rare case of bilateral retinal infiltration in an adult patient with relapse Acute Lymphoblastic Leukemia L1 B-lineage.
Methods
A case report
Results
A 20-year-old patient came to our policlinic with a complaint of sudden blurry vision in his right eye for five days. Floaters were denied. He has a history of acute lymphocytic leukemia for two years and has already received complete response treatment from his previous chemotherapy in 2023. He also complained about his asymmetrical face which occurred 5 days after his ocular symptoms. Visual acuity was 0.6 in his right eye and 1.0 in his left eye. Both anterior segments were unremarkable. Posterior segment examination in both eyes showed a whitish mass size 2-disc diameter covering the optic nerve. Orbital ultrasound showed hyperechoic sub-retinal mass located anterior from the optic nerve in both eyes, along with vitreous strand in his right eye. Cytology assessment revealed leukocytes, macrophages, and debris cells in vitreous fluid. Leukemia phenotyping evaluation described several particles with 3% blast cells and minimal residual diseases (MRD) were negative. Brain MRI was scheduled to search for intracranial metastasis. He also plans to continue his systemic chemotherapy.
Conclusion
Ophthalmic manifestations in leukemia can adversely affect vision and have a principal role in predicting the survival prognosis of systemic leukemia. Ocular findings in any patient with a history of leukemia should raise the possibility of relapse; therefore, ophthalmology examination is recommended in all leukemia patients to detect any ocular complications at an early stage. Prompt diagnosis and early treatment are paramount to preserving vision and patient’s survival.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Rizky | Syawaluddin Djamal | Dharmais National Cancer Center |
| Dwi | Wahyunianto Hadisantoso | Dharmais National Cancer Center |
| Rizky | Ifandriani Putri | Dharmais National Cancer Center |
