Unusual ophthalmic manifestation in chronic myeloid leukemia: A case report

Background: Chronic myeloid leukemia (CML) is a myeloproliferative hematopoietic malignancy with a heterogeneous proliferation of hematopoietic cells in the bone marrow. The ocular manifestations are rare symptoms of CML. In this case report, a CML patient with retinal hemorrhage is reported as an uncommon symptom. Case presentation: A 35-year-old man was referred due to decreased right eye vision. The reduction of the visual acuity of the right eye (2/10), rounded and diffuse intra-retinal hemorrhage with white-center Roth’s spots, and macular edema were seen. No systemic diseases and other ophthalmic manifestations were seen in this case. The white blood cell (WBC) count was 135,000 cells/ μl, the platelets were 430,000 cells/μl, and hemoglobin was 12.5 gr/dl. The myeloid progenitor and precursor were present in peripheral blood smear and bone marrow. Also, the quantitative real-time polymerase chain reaction indicated that the BCR-ABL1-to-ABL1 ratio was 0.795. a daily administration of 400 mg of Imatinib was prescribed. Two months later, WBC count reached 6,500 cells/μl, Hb was 11.6 gr/dl, and platelets were 306,000 cells/μl. Conclusion: The ophthalmic manifestations may be a symptom of CML. We found the rounded and diffuse intra-retinal hemorrhage, Roth’s spots, and macular edema as the ocular manifestation of a CML case.