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KMID : 0360220210620040571
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Journal of the Korean Ophthalmological Society
2021 Volume.62 No. 4 p.571 ~ p.576
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Differentiation Syndrome with Ocular Manifestations in Acute Promyelocytic Leukemia Patients Treated with All-trans Retinoic Acid
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Oh Si-Eun
Choi Seung-Yong
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Abstract
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Purpose: To report a rare case of differentiation syndrome with ocular manifestations in a patient with acute promyelocytic leukemiatreated with all-trans retinoic acid (ATRA).
Case summary: A 27-year-old female complained of yellowing of vision and decreased visual acuity during an ATRA medicationcourse for acute promyelocytic leukemia. Bilateral diffuse drusen-like lesions were found at the posterior pole along with multiplepigment epithelial detachment on optical coherence tomography (OCT) scans. Fluorescein angiography showed multiple hyperfluorescentlesions with leakage at the late phase corresponding to drusen-like lesions in fundus photography. Indocyaninegreen angiography revealed multiple hypocyanescent lesions. ATRA treatment was discontinued and replaced with high-dosedexamethasone. Accordingly, the patient experienced a rapid improvement in visual symptoms and the chorioretinal lesions onOCT scans showed marked resolution.
Conclusions: Differentiation syndrome-associated chorioretinopathy may occur in patients with acute promyelocytic leukemiatreated with ATRA. Because the occurrence of chorioretinopathy may be associated with systemic aggravation of the ATRA syndrome,preemptive treatment with early detection is required.
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KEYWORD
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Acute promyelocytic leukemia, All-trans retinoic acid, Chorioretinopathy, Differentiation syndrome
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