Abstract
Objective and importance: Imatinib–the principle treatment currently available for chronic myeloid leukemia (CML)–may be implicated in neovascular glaucoma (NVG) pathogenesis. Clinical presentation: A 64 year old diabetic female develops CML and receives imatinib treatment develops aggressive bilateral neovascular glaucoma within 1 month of initiation of treatment. The left eye is lost and the right eye was hardly salvaged through panretinal photocoagulation and substitution of imatinib therapy to desatinib therapy. Intervention: Systemic imatinib therapy for CML. Conclusion: Imatinib may be implicated in the causation of NVG in CML patients, who should thus receive regular thorough ophthalmic evaluation as long as imatinib therapy continues.
Highlights
Chronic myelogenous leukemia (CML) is a pluripotent stem cell disease characterized by anemia, extreme blood granulocytosis and granulocytic immaturity, basophilia, often thrombocytosis, and splenomegaly
The first tyrosine-kinase inhibitor imatinib was introduced to clinical practice about 10 years ago and it radically improved the outcome of CML patients
Though no data is available about the pre-imatinib vision and IOP of the patient, yet the patient reportedly had -at least apparently- a level of vision that was judged by the patient as normal allowing free full mobility and independence in life tasks
Summary
Chronic myelogenous leukemia (CML) is a pluripotent stem cell disease characterized by anemia, extreme blood granulocytosis and granulocytic immaturity, basophilia, often thrombocytosis, and splenomegaly. The first tyrosine-kinase inhibitor imatinib was introduced to clinical practice about 10 years ago and it radically improved the outcome of CML patients. Owing to the relatively high cost of the laboratory investigations, not all necessary tests (e.g. quantitative bcr/abl analysis, ratio of Ph chromosome positive cells) could be ordered freely from the patient.
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