Leukemic hypopyon in acute myeloid leukemia

PURPOSE. Leukemic hypopyon uveitis in acute myeloid leukemia (AML) is a very rare condition. We report this case of an unusual finding in a 2(1/2)-year-old boy in second remission after chemotherapy for relapsed AML. METHODS. A young patient with an AML FAB M5 in second remission developed pain, photophobia, and conjunctival injections in the right eye. Recent bone marrow aspiration showed no blast increase and recent peripheral blood sampling presented no evidence of relapse. RESULTS. The patient showed a viscous hypopyon and a myotic pupil in the right eye that was refractory to corticosteroids. Anterior chamber aspiration revealed atypical blasts similar to the leukemic cells that were found in the bone marrow aspirate at the time of systemic relapse. CONCLUSIONS. Timely anterior chamber aspiration and subsequent cytology is useful in differentiating leukemic hypopyon from true intraocular inflammation in AML patients. This is the first report about a leukemic hypopyon uveitis in AML without systemic findings of malignant cells in a child.