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A 51-year-old woman with binocular diplopia and unilateral ptosis
Digital Journal of Ophthalmology 2019
Volume 25, Number 3
August 18, 2019
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Landon J. Rohowetz, BS | University of Missouri – Kansas City School of Medicine, Kansas City, Missouri
Anjulie K. Quick, MD | Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas
Intrathecal chemotherapy was started on day 3, and the patient was discharged 4 days later with plans for weekly intrathecal chemotherapy (Figure 3). The patient’s ophthalmic signs and symptoms, including diplopia, ptosis, and misalignment resolved 1 month after initiation of intrathecal chemotherapy. This coincided with the dissipation of myeloid blasts from the CSF. She has experienced no ophthalmic symptoms in the ensuing 8 months.

There was a brief reappearance of CSF myeloid blasts about 5 months after initiation of intrathecal chemotherapy that again resolved within 1 month. At 9 months, the patient’s bone marrow biopsy and CSF analysis revealed no phenotypic evidence of AML, and the patient was deemed in complete remission.
Figure 3
Timeline and hospital course. Imaging was obtained emergently to rule out aneurysm, followed by definitive diagnosis with lumbar puncture and treatment. AML, acute myeloid leukemia; CTA, computed tomography angiogram; MRA, magnetic resonance angiogram; MRI, magnetic resonance imaging.