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Y. Terada, I. Takasu, H. Ohtsuki; Bilateral Macular Invasion Following Severe Retinopathy of Acute Promyelocytic Leukemia . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5406.
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Purpose: Present a case of bilateral macular invasion following leukemic retinopathy and vitreous hemorrhage in a Japanese male with acute promyelocytic leukemia. Methods: Case report. Results: Case: A 35–year–old Japanese male who experienced sudden visual loss in his both eyes and multiple subcutaneous hemorrhages was referred to our hospital. His visual acuity was hand motion in his right eye and counting fingers in his left eye. Fundus examination showed multiple blot hemorrhages including Roth’s spots, preretinal hemorrhages and vitreous hemorrhage in his both eyes. Upon further evaluation, his complete blood count and bone marrow biopsy revealed the diagnosis of acute promyelocytic leukemia (APL, M3) with disseminated intravascular coagulation. We performed Nd:YAG laser photodisruption for dense preretinal hemorrhage in his left eye and his visual acuity improved to 20/30. After standard induction and consolidation chemotherapy, he received vitrectomy in his right eye and his visual acuity improved to 20/30 as well. Systemically, he was brought to complete remission. However, 6 months after the vitrectomy, submacular retinal invasion in his both eyes grew larger and his visual acuity gradually decreased. We performed biopsy of the subretinal material and vitreous in his left eye, but tumor cell was not detected. Conclusions: Nd:YAG laser photodisruption and vitrectomy were effective for vitreous and preretinal hemorrhages in a patient with APL. However, isolated submacular lesions grew larger even if his systemical complete remission, which could be tumor infiltration that have not been confirmed despite of biopsy.
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