Double Pizza Pie

A 59-year-old woman with a past medical history of primary refractory acute myeloid leukemia GATA2, KRAS, NRAS, and U2AF1 mutations, presented with gradual onset of blurry vision over the course of 1.5 months. Her ophthalmic exam was remarkable for intraretinal, subretinal, and preretinal hemorrhages 360 OU and bilateral optic disc edema. Fluorescein angiography showed bilateral central retinal vein occlusions. CT venogram demonstrated multifocal areas of intraparenchymal hematomas and subarachnoid hemorrhage and superior sagittal sinus thrombosis. These findings are consistent with bilateral central retinal vein occlusion from superior sagittal sinus thrombosis secondary to severe coagulopathy and thrombocytopenia related to acute myeloid leukemia.