gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Hyperviscosity syndrome and atypical retinal infiltrates associated with chronic lymphatic leukaemia

Meeting Abstract

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  • corresponding author T. M. Herbold - Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster
  • H. Busse - Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster
  • C. E. Uhlig - Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.01.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog163.shtml

Published: September 22, 2004

© 2004 Herbold et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

A 22-year-old female patient in the 30th week of gestation of her first pregnancy, was referred with the suspected diagnosis of hyperviscosity syndrome for ophthalmological treatment and cardiovascular investigation. The patient complained of central visual loss in her left eye.

Methods

The following investigations were performed: visual acuity, tonometry, perimetry, amsler-chart-test, fundoscopy, photo-documentation, gynaecological and medical referral. The patient was followed-up for 10 months.

Results

Best visual acuity was 0.5 (left eye) and 1.0 (right eye). Amsler grid re-vealed metamorphopsia of the left eye. The anterior segments of the eye were normal including a transparent cornea and lens. Fundoscopy showed panretinal tortuosity, congestion of retinal vessels, small haemorrhages and white, irregular retinal areas were found next to the vessels and centrally. Submandibular and cervical lymph nodes were swollen. A full blood count revealed a leucocytosis and a left shift of the white blood cells due to chronic lymphatic leukaemia. The first line treatment was leucophoresis, so that the foetus was not endangered. After the normal birth of a healthy child, chemotherapy was commenced. After ten months of treatment there was evidence of paravascular focal pigment epitheliopathy, but no other abnormalities.

Conclusions

Our case-report outlines the importance of complex differential diagnoses in patients with congestion of retinal vessels. This should include haematological pathology, as it may be an unusual presentation even in an other-wise healthy young patient.