Abstract

A 9 year old female child, K/c/o B-ALL who has completed chemotherapy, was referred from ICH to r/o uveitis. Re) Vn was 6/6, and Le) 6/36 NIGNIP. S/L/E was normal. Fundus examination, Re) was normal Le) Media was mildly hazy due to vitreous consensation, disc showed mild pallor. Arteriolar attenuation was present. Extensive exudation with few crystalline deposits along veins in STQ and ITQ. Retinal and macular edema was present. A diagnosis of frosted branch angiitis was made.
CBC, RBS, RFT were all normal. CXR, CRP, ANA tests were done. CRP was 48mg/dl. VCTC, VDRL -ve. TORCH panel: IgM CMV and IgM HSV +ve. But CD4 levels and CD4/CD8 ratio were normal, so CMV retinitis was ruled out and we diagnosed the child with Frosted Branch Angiitis secondary to direct leukemic infiltration.
We started Le) Prednisolone e/d 1° 6tid, tapering over one week. She was referred to Medical Oncology and reviewed after 2 months. Le) Vn improved to 6/12. She is now on regular followup.