Abstract
A patient with a past medical history of leiomyosarcoma treated with chemotherapy presents to the emergency room with nausea, generalized weakness, and emesis. The patient was subsequently admitted for systemic evaluation. During the course of admission, the patient endorsed blurry vision and eye redness. Ophthalmic examination demonstrated visual acuity of 20/20 in the right eye and 20/25 in the left. Intraocular pressures were normal. Slit lamp examination demonstrated a small inferior subconjunctival hemorrhage in the right eye. Dilated fundus examination showed dot blot hemorrhages, Roth spots, and subretinal hemorrhage in the right eye. The left eye had similar features with the addition of a superotemporal exudative retinal detachment. One day later the patient had worsening blurry vision with acuity of HM in the right eye and CF in the left. Examination demonstrated dense bilateral vitreous hemorrhage in both eyes. Systemic workup showed leukocytosis, anemia, and thrombocytopenia with a bone marrow biopsy demonstrating blast cells, leading to a diagnosis of acute myeloid leukemia and an ophthalmic diagnosis of leukemic retinopathy. Following discharge, the patient was taken to the operating for pars plana vitrectomy with eventual improvement of vision to 20/150 in the right eye and 20/40 in the left eye.
Presentation Date: 10/23/2025
Issue Date: 03/06/2026
