Kissing choroidal detachment in acute lymphoblastic leukemia

Abstract

The presence of serous retinal detachment as a sign of choroidal infiltration, although extremely rare, can be a manifestation of acute leukemia. A 6-year-old boy with T-cell acute lymphoblastic leukemia was referred to the Department of Ophthalmology of Jichi Medical University for a week-long history of blurry vision. He had been undergoing chemotherapy for leukemia for the previous week. Routine visual acuity measurements were not feasible, because the examination was performed at a bedside visit. Ophthalmoscopic examination revealed marked pre- and intraretinal hemorrhages overlying the optic disc (arrow) associated with “kissing” choroidal detachment in the right eye. A complete blood count result showed a white-cell count of 398,200/mm3 (reference range, 3300–8600/mm3), with 95% blasts, a red-cell count of 3,980,000/mm3 (reference range, 4,350,000–5,550,000/mm3), hemoglobin level of 10.7 g per deciliter (reference range, 13.7-16.8), and a platelet count of 99,000/mm3 (reference range, 158,000–348,000/mm3). Vitreous hemorrhage developed after 2 months, and his visual acuity decreased to light perception in the right eye.