DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.040

Pages: 2293-2296

Acute myeloid leukemia [AML] is a hematological malignancy characterized by the accumulation of immature myeloid cells in the bone marrow and peripheral blood. Ocular manifestations are frequent and may result from direct leukemic infiltration, hematological abnormalities, or opportunistic infections. We report a case in which acute bilateral visual loss was the inaugural manifestation of AML type 5. A 26-year-old woman with no prior medical history presented with sudden bilateral visual loss associated with asthenia, dyspnea, and amenorrhea. Fundoscopic examination revealed bilateral papilledema, Roth spots, peripapillary hemorrhages, and macular star exudates consistent with leukemic retinopathy. Laboratory workup demonstrated severe pancytopenia, and bone marrow biopsy confirmed AML type 5. The patient received transfusion support and standard chemotherapy. At eight weeks, visual acuity improved from 20/50 to 20/25 bilaterally, with near-complete fundoscopic resolution and normalization of retinal nerve fiber layer thickness on OCT. This case underscores the diagnostic significance of ophthalmic examination in detecting underlying hematological malignancies. The triad of papilledema, retinal hemorrhages, and Roth spots in a young patient with systemic symptoms should prompt urgent hematological workup. Close ophthalmologist-hematologist collaboration is essential to optimize both visual and vital prognosis.