This site uses tracking information. Visit our privacy policy. Click to agree to this policy and not see this again.

Ophthalmology and Visual Sciences

Leukemic pseudohypopyon

Leukemic pseudohypopyon

Category(ies): Uveitis, Retina/Vitreous
Contributor: Lauren E. Hock, MD; James C. Folk, MD
Photographer: Sarah L. Skiles, CRA

Pseudohypopyon is a relatively rare manifestation of leukemia. It occurs most often in patients with acute lymphoblastic leukemia and may be seen during a blast crisis or as a sign of relapse [1]. Rapid development of an atypical, blood-stained hypopyon that fails to respond to corticosteroid therapy is classic for leukemic pseudohypopyon [2]. Pseudohypopyon is distinguished from infectious or inflammatory hypopyon by the absence of an associated fibrin reaction. This pseudohypopyon was the first sign of this 56-year-old patient's acute lymphoblastic leukemia relapse. Timely anterior chamber aspiration with cytology and systemic malignancy work-up are paramount to ensuring appropriate diagnosis and treatment.

 Slit lamp photograph of the left eye shows mild injection, clear cornea, and presence of a 3.5 mm blood-tinged pseudohypopyon in the anterior chamber
Figure 1. Slit lamp photograph of the left eye shows mild injection, clear cornea, and presence of a 3.5 mm blood-tinged pseudohypopyon in the anterior chamber with 4+ fine cell and no fibrin. Leukemic pseudohypoyon may present bilaterally, but this patient's right eye was unaffected.
 presence of gelatinous fibrovascular lesions along the pupillary margin and peripheral iris
Figure 2. Slit lamp photograph of the iris of the left eye highlights the presence of gelatinous fibrovascular lesions along the pupillary margin and peripheral iris.
Reference:
  • Yi, D.H., et al., Acute unilateral leukemic hypopyon in an adult with relapsing acute lymphoblastic leukemia. Am J Ophthalmol, 2005. 139(4): p. 719-21.
  • Ramsay, A. and S. Lightman, Hypopyon uveitis. Surv Ophthalmol, 2001. 46(1): p. 1-18.

Image Permissions:
Creative Commons

Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.