Combined orbital proptosis and exudative retinal detachment as initial manifestations of acute myeloid leukemia

J AAPOS. 2015 Oct;19(5):479-82. doi: 10.1016/j.jaapos.2015.05.018.


We report bilateral orbital and choroidal involvement as the presenting sign of acute myeloid leukemia in a 2-year-old white girl. The patient presented with painless proptosis and subconjunctival hemorrhage. Ophthalmic examination and magnetic resonance imaging revealed bilateral leukemic infiltrates of the orbits and choroid, with an exudative retinal detachment in the right eye. Bone marrow biopsy confirmed acute myeloid leukemia. Following radiation treatment, chemotherapy, and hematopoietic stem cell transplantation, the patient was doing well 12 months after presentation. Outcomes can be poor, even with treatment; prompt recognition of ophthalmic manifestations of leukemia, including proptosis, choroidal infiltration, and retinal detachment, is necessary.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Child, Preschool
  • Choroid Neoplasms / diagnosis*
  • Choroid Neoplasms / therapy
  • Combined Modality Therapy
  • Exophthalmos / diagnosis*
  • Exophthalmos / therapy
  • Exudates and Transudates
  • Female
  • Flow Cytometry
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Myeloid, Acute / diagnosis*
  • Leukemia, Myeloid, Acute / therapy
  • Magnetic Resonance Imaging
  • Microscopy, Acoustic
  • Multimodal Imaging
  • Orbital Neoplasms / diagnosis*
  • Orbital Neoplasms / therapy
  • Radiotherapy
  • Retinal Detachment / diagnosis*
  • Retinal Detachment / therapy


  • Antineoplastic Agents