Journal
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
Volume 246, Issue 10, Pages 1495-1497Publisher
SPRINGER
DOI: 10.1007/s00417-008-0838-z
Keywords
leukemia; retinal infiltrates; fine needle aspiration biopsy; toxoplasmosis; immunosupression
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Funding
- Research to Prevent Blindness, Inc., New York
- University of Cincinnati College of Medicine
- Department of Ophthalmology, University of Cincinnati College of Medicine
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Background Acquired multifocal white retinal lesions in an immunosuppressed patient are diagnostically challenging. Methods Case report of a 34-year-old woman who underwent bone marrow transplantation for chronic myelogenous leukemia. Four months after the transplant, while on relatively high doses of immunosuppressive drugs, she developed bilateral multifocal retinitis versus leukemic retinal infiltration. Fine-needle aspiration biopsy was performed on one eye in an attempt to establish a cytological diagnosis. Results The aspirate was found to contain individual crescent-shaped intraretinal organisms and cysts, consistent with the diagnosis of toxoplasmic retinitis. The patient was started immediately on an anti-toxoplasmosis regimen consisting of sulfadiazine, pyrimethamine, and folinic acid. Follow-up examinations revealed complete inactivation of the retinitis and no delayed complications of the biopsy. Conclusion Fine-needle aspiration biopsy can be a useful diagnostic tool in selected patients with acquired retinal infiltrates.
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