First Author: L.Vieira PORTUGAL
Co Author(s): N. Silva A. Vicente A. Cabugueira R. Anjos R. Flores V. Maduro 0 0 0 0 0 0 0 0 0
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To describe a case of bilateral serous macular detachment as a presenting sign of acute lymphoblastic leukemia in an adult.
Centro Hospitalar Lisboa Central
A complete ophthalmic and systemic evaluation was performed on a patient of 63 years, who was admitted to the Emergency Room with decreased visual acuity, with 2 weeks of evolution .
We describe a case of a patient with painless and progressive loss of visual acuity (right eye 2/10 and left eye 3 /10) in 2 weeks, which also had fever and cervical lymphadenopathy. Fundus examination showed bilateral macular serous detachment, confirmed by optical coherence tomography (central macular thickness on the right eye was 638μm and on the left eye was 423μm). Fluorescein angiography revealed hyperfluorescent pinpoints in the posterior pole. In the late phase of the angiogram, the limits of the macular detachment were revealed. The changes found in the blood count triggered a more extensive systematic study. The diagnosis of acute lymphoblastic leukemia B ( CD10 + ) was made. Intensive systemic chemotherapy was started immediately.
This case illustrates the importance of a systematic study face a bilateral macular serous detachment without other signs suggestive of local injury, even in an adult patient. This is particularly important when early treatment is imperative and patient survival depends on it.