A 30-year-old female with a diagnosis of Chronic Myeloid Leukemia (CML) was referred to the ophthalmology clinic due to newly developed visual decline. Best-corrected visual acuity was 1.0 in the right eye and 0.3 in the left. Intraocular pressures measured 12 mmHg bilaterally, and anterior segment examination was unremarkable. Dilated fundus evaluation revealed bilateral Roth spots, a characteristic finding associated with hematologic disorders and microvascular ischemia linked to hyperviscosity. No venous tortuosity or vascular engorgement was noted. Optical coherence tomography showed no intraretinal or subretinal fluid in either eye, and peripapillary RNFL thickness values (86 µm OD, 88 µm OS) were within normal limits. In the context of CML, the presence of Roth spots was considered indicative of active hematologic burden with retinal microvascular compromise. The patient was scheduled for close ophthalmic follow-up, and systemic reassessment was recommended in collaboration with hematology due to the clinical significance of these retinal findings.
Color fundus photography and red-free photography of a patient with Roth spots secondary to CML 
Credit: Trakya University Ophthalmology Clinic
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