To present a case of bilateral retinal vasculopathy as the first manifestation of chronic myelogenous leukemia.

A 59-year-old man with no medical history such as diabetes, hypertension and no ocular history complained of decreased visual acuity for 1 month. Fundus examinations showed diffuse multiple dot and blot hemorrhages over the panretina of both eyes and vessels showed tortuous vascular changes. The fluorescein angiogram was evaluated, and showed diffuse microaneurysms at the peripheral retina and posterior pole. Hematologic and biochemical examinations as well as a carotid sonogram were performed based on the possibility of systemic disease. The patient showed hematologic abnormality and therefore was transferred to internal medicine for diagnosis of chronic myelogenous leukemia.

The authors examined a chronic leukemia patient, who showed bilateral retinal vasculopathy as the first manifestation of chronic myelogenous leukemia. This case shows the importance of considering the possibility of systemic disease.