Serous Retinal Detachment in a Pediatric Case with Acute Lymphoblastic Leukemia as a First Sign of Leukemic Relapse - Abstract
A 7 year-old boy with T-cell acute lymphoblastic leukemia (T-ALL) was under treatment according to the ALL BFM 2000 protocol. Cerebrospinal fluid analysis did not reveal any blast cells at the beginning of the therapy. The patient developed bilateral visual loss at the third month of therapy. In the fundus examination there was bilateral optic disc edema, and serous retinal detachment with subretinal infiltrates. The patient with his bone marrow in remission was treated by systemic and intratechal chemotherapy combined with craniospinal and orbital radiotherapy. Subretinal fluid began to resolve and visual acuity improved, 24 hours after initiation of systemic and intratecal chemotherapy. The patient died of bone marrow relapse during preparation period for bone marrrow transplantation. Acute visual loss due to serous retinal detacment may be the first sign of relapse in ALL. Detailed ophthalmic examination should be performed in patients with leukemia as early diagnosis and prompt treatment is critical.