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

TL;DR

A rare case of eye problems signaling a relapse of blood cancer is presented, showing the importance of eye exams in cancer care.

Contribution

The case highlights multifocal ocular signs as potential early indicators of AML relapse.

Findings

AML relapse presented with simultaneous anterior and posterior ocular involvement.

Ocular structures may act as sanctuary sites for leukemic cells.

Collaboration between ophthalmologists and hematologists is crucial for managing such cases.

Abstract

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.

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