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. 2022 Apr 16;34(1):100-105.
doi: 10.4103/joco.joco_10_21. eCollection 2022 Jan-Mar.

Ocular Manifestations of Newly Diagnosed Acute Leukemia Patients

Reza Mirshahi  1 , Fariba Ghassemi  2 , Leili Koochakzadeh  3 , Mohammad Faranoush  4 , Zahra Ghomi  5 , Azim Mehrvar  6 , Seyed Asadollah Mousavi  7 , Seyyed Reza Safaee Nodehi  8
Affiliations

Ocular Manifestations of Newly Diagnosed Acute Leukemia Patients

Reza Mirshahi et al. J Curr Ophthalmol. .

Abstract

Purpose: To present primary ocular manifestations in acute leukemia.

Methods: This cross-sectional descriptive hospital-based study evaluated all newly diagnosed leukemia patients of three referral hospitals of Tehran University of Medical Sciences in 2015-2016 and Mahak Hospital in Tehran in 2017. Exclusion criteria included the patients with the previous history of chemotherapy, cases of relapsing disease, and the patients with a history of ocular disease or other systemic conditions with ophthalmic manifestations.

Results: A total of 85 patients (170 eyes) were evaluated in our study, including 29 children (34.1%) and 43 females (50.6%). The mean patient age was 37.84 ± 11.91 years in the adult group and 6.28 ± 4.70 years in the pediatric category. Ophthalmic involvement was seen in 27 patients (31.8%), including 6 pediatric patients (20.7%) and 21 adult patients (37.5%). Two patients (2.3%) had direct infiltration by leukemic cells and 76 patients (89.41%) of patients were asymptomatic. There was a correlation between ophthalmic involvement and platelet count and hemoglobin level. In patients with ocular signs, higher mortality rates were observed.

Conclusions: At the time of diagnosis in acute leukemia patients, complete ophthalmic evaluation including dilated fundus examination is suggested as ocular involvement in these patients is common and sometimes asymptomatic. Ophthalmic involvement in leukemic patients should be identified in a timely manner, particularly in individuals with low platelet counts and hemoglobin levels, due to the potential prognostic relevance.

Keywords: Acute leukemia; Acute lymphoblastic leukemia; Acute myeloid leukemia; Leukemia; Ocular leukemic infiltration; Ophthalmic manifestation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Fundus photo of a patient showing bilateral optic disc edema with peripapillary subretinal hemorrhage in the left eye
Figure 2
Figure 2
Fundus photo of the left eye of a patient with concomitant vitreous hemorrhage, Roth's spot, retinal and subhyaloid hemorrhage
Figure 3
Figure 3
Subhyaloid hemorrhage that was treated by YAG hyaloidotomy (left image). Fundus photo of the same eye a few days later with considerable hazy media due to vitreous hemorrhage (right image)
Figure 4
Figure 4
Receiver operating characteristic curve of minimum hemoglobin level with an area of 0.813 under the curve for detection retinal hemorrhage
Figure 5
Figure 5
Receiver operating characteristic curve of minimum platelet number with an area of 0.813 under the curve for detection retinal hemorrhage
See this image and copyright information in PMC

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