Entopic Phenomenon as Initial Presentation of Acute Myelogenous Leukemia

Caroline Laforest; Dinesh Selva; John Crompton; Igal Leibovitch

doi:10.7326/0003-4819-143-11-200512060-00025

Letters |6 December 2005

Entopic Phenomenon as Initial Presentation of Acute Myelogenous Leukemia

Caroline Laforest; Dinesh Selva, MBBS; John Crompton, MBBS; Igal Leibovitch, MD

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TO THE EDITOR:

Background: About half of adult patients with acute myelogenous leukemia experience ocular involvement (1), most commonly leukemic retinopathy. In most of these cases, the retinopathy is asymptomatic (1-4).

Objective: To describe a patient with acute myelogenous leukemia whose initial presentation was a unique entoptic phenomenon.

Case Report: A 22-year-old man was referred to the ophthalmology clinic for evaluation of a superior dark semicircular shape in the central vision of his left eye that he had first noted 3 days earlier. The shape was fixed in position with movement of the eye. When the patient leaned forward, the dark semicircle increased in size, forming a full oval-shaped scotoma, and his vision became dark and clouded. As the patient returned to an upright position, his vision slowly improved and the scotoma regained its semicircular configuration. The patient also reported a 3-week history of malaise, fever, nausea, and vomiting. He had never used illicit drugs and took no regular medications.

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2005 American College of Physicians

Letters |6 December 2005

Entopic Phenomenon as Initial Presentation of Acute Myelogenous Leukemia

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Letters |6 December 2005

Entopic Phenomenon as Initial Presentation of Acute Myelogenous Leukemia

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