IMAGES IN MEDICINE
Pan retinal haemorrhages in acute myeloid leukaemia
Department of Ophthalmology, Ayr Hospital, Ayr, UK
Correspondence to:
Mr S Srinivasan, Department of Ophthalmology, Ayr Hospital, Dalmellington Road, Ayr KA6 6DX, UK; sathish.srinivasan@gmail.com
Keywords: acute myeloid leukaemia; retinal haemorrhages; macular haemorrhages; pancytopenia; thrombocytopenia
| The first 150 words of the full text of this article appear below. |
A 41-year-old man with no past ophthalmic history presented with sudden loss of vision in the left eye. Four weeks before presentation to the ophthalmology department he was diagnosed with acute myeloid leukaemia (AML). Haematological examination revealed pancytopenia. White cell count was 1.9x109/l, neutrophils 0.8x109/l, and platelets 19x109/l, with the blood smear showing an occasional large blast cell. AML M6 was confirmed by bone marrow biopsy.
Visual acuity was 6/6 in the right eye and counting fingers in the left eye. Fundal examination showed extensive superficial nerve fibre layer haemorrhages with Roth’s spots, and intraretinal and subretinal haemorrhages involving the macula bilaterally (fig 1). Over 3 months the haemorrhages resolved but a residual premacular membrane has resulted in a poor visual outcome in the left eye. Initial chemotherapy as part of a clinical trial was unsuccessful with repeat bone
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