Bilateral vision loss as initial presentation of chronic myeloid leukemia in a young adult: A case report and review of the literature

Abstract

Purpose: To report a case of bilateral vision loss as the primary presenting symptom of chronic myeloid leukemia in a young adult. Observations: The 28-year-old male patient presented to clinic with visual acuity of 20/200 in both eyes after several months of episodic bilateral vision loss. Intraretinal and pre-retinal hemorrhages were appreciated, as well as Roth spots and peripheral neovascularization. Initial lab findings were consistent with a diagnosis of acute myeloid leukemia, later, upon bone marrow examination, the diagnosis was edited to chronic myeloid leukemia. Dasatinib therapy resulted in a complete hematologic resolution after six weeks. After intravitreal injections of bevacizumab in both eyes, visual acuity improved to 20/25 in the right eye and 20/20 in the left eye. Conclusion and importance: After review, this is one of only a few reported cases of bilateral blurry vision as the primary presenting symptom of chronic myeloid leukemia in a young adult. Because visual disturbances occur more frequently in acute myeloid leukemia, and lab results may be inconclusive, careful consideration should be given to differentiate myelogenous leukemias, as the acute and chronic subtypes may present similarly.

Keywords

• Chronic myeloid leukemia
• Vision loss
• Leukemic retinopathy
• Retinal hemorrhage
• Roth spots
• Dasatinib