Ocular involvement in pediatric patients with acute leukemia relapse: points of diagnosis and treatment

In consequence of the development of modern chemotherapy protocols, the prognosis for children with acute leukemia(AL) has significantly improved, which has allowed achieving high survival rates. However, despite these achievements, relapses and refractory course of AL are not uncommon. Extramedullary relapses with the kidneys, gonads, soft tissues, central nervous system and eyes involvement are especially difficult to diagnose. Clinical manifestations of eye involvement in AL can be represented by decreased vision, swelling of the optic disc, exophthalmos, due to infiltration of the optic nerve and intraorbital tissues by leukemic blasts. The alertness of pediatric oncologists and ophthalmologists regarding the possibility of AL relapses with eye localization should determine the scope of examination, including MRI, retinal camera examination, spinal tap and morphological and immunological verification of the pathological process. unfortunately, intraocular AL relapses currently often have an extremely poor prognosis.