CHOROIDAL INFILTRATION IN MYELODYSPLASTIC SYNDROME

Background Myelodysplastic syndrome is a clonal disease of the hematop oetic system characterized by insufficiency of affected bone marrow ce ll lines. After long-term course of myelodysplastic syndrome an accele ration towards acute myeloic leukemia is a frequent finding. Involveme nt of the eye is a well known phenomenon in acute leukemia or in blast crisis with chronic leukemias. Eye involvement in myelodysplastic syn drome showing its transition into acute myeloic leukemia however has b een published in only few cases. Case report We present a 70-year-old male patient suffering from myelodysplastic syndrome, complaining of a n acute visual decrease to 0.05 in the left eye. Clinical findings, ul trasound and fluoresceine angiography were in accordance with choroida l infiltration. From the hematologic findings, the myelodysplastic syn drome had been in partial remission after chemotherapy without any sin of relapse or exacerbation. Only because of the ophthalmologic diagno sis, bone marrow aspiration was performed and revealed progression of myelodysplastic syndrome to acute myeloic leukemia. Prompt administrat ion of chemotherapy and external radiation of the posterior pol of the eye led to complete resolution of the fundus lesion within 10 days an d visual acuity recovered to 0.8. Conclusion To the best of our knowle dge this is the first patient with a choroidal infiltration as the ini tial sign of progression of myelodysplastic syndrome to acute myeloic leukemia. Realizing this possibility helps for an early diagnosis and rapid therapy which is so crucial in prolonging life.