Anemic Retinopathy as a Sign of Acute Myeloid Leukemia

Anemia and other hematologic disorders have far-reaching systemic and ocular manifestations. Hypoxia of ocular tissues can be an indicator of life-threatening conditions and can be visually detrimental to patients. In this case report, the ocular manifestations of retinal ischemia as a precursor to a diagnosis of acute myeloid leukemia in a patient with a complaint of acute onset blurry vision are discussed. Exam findings revealed flame and dot-blot retinal hemorrhages, vascular tortuosity, and mild unilateral disc edema. Lab testing showed a critically low hemoglobin value and other cellular signs of macrocytic anemia. Treatment with a blood transfusion and B12 supplementation was unsuccessful. A bone marrow biopsy revealed few maturing myeloid cells consistent with a diagnosis of acute myeloid leukemia. The patient was referred to oncology for treatment with chemotherapy and achieved remission after three cycles. Knowledge of the signs of ocular ischemia, indicated lab testing, and appropriate co-management is crucial to early diagnosis and treatment of these life-threatening conditions.