Serous retinal detachment in an elderly patient with Philadelphia- chromosome-positive acute lymphoblastic leukemia

Purpose: To describe an elderly woman who presented with a serous retinal detachment (SRD) as the first sign of Philadelphia-chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL). Design: Observational case report. Methods: A complete ophthalmic and systemic evaluation was performed on a 62-year-old woman because of decreased vision of 20/60 OD and 20/25 OS. Results: Fundus examination revealed a SRD involving the fovea, OU. Fluorescein angiography disclosed multifocal spots of hyperfluorescence in the early phase, and diffuse subretinal accumulation of fluorescein in the late phase. She was diagnosed with Ph⁺ ALL because of systemic findings. She underwent systemic chemotherapy and went into complete remission. Visual acuity improved to 20/20 in both eyes with resolution of the bilateral SRD. Conclusions: Our observations indicate that a sudden appearance of SRD, even in an elderly patient, warrants a thorough systemic screening for underlying leukemia. This is especially important, because prompt systemic chemotherapy can improve the visual acuity and the prognosis.