Ocular manifestations in acute lymphoblastic leukemia: A five-year cohort study of pediatric patients

Mendonça, Cléverton de Oliveira; Freire, Marcelle Vieira; Viana, Simone Santana; Tavares, Mayo Kayann Guerra Silva; Silva, Wallace Marcelo Almeida; Cipolotti, Rosana

doi:10.1016/j.leukres.2018.11.017

Cited by 26 publications

(26 citation statements)

References 19 publications

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“…Ophthalmic manifestations have been reported in the literature with different prevalence from study to study, ranging from 24% to 70% [4,[8][9][10][13][14][15][16][17]. Also, some studies that have been done in Saudi Arabia reported prevalence ranging from 35%-54%; however, these studies are old and published in the '90s [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

Bukhari¹,

Alzahrani²,

Alqarni³

et al. 2021

Cureus

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Background: Leukemia is a neoplastic disorder that affects blood and bone marrow and is characterized by white blood cells' abnormal proliferation. Leukemia patients may present with different ophthalmic manifestations. This study aims to provide an updated data about the prevalence and types of ocular manifestations in acute leukemia patients and their relation with the hematological parameters. Methods: This retrospective cross-sectional study included all acute leukemia patients diagnosed from 2015 to 2020 and underwent an ophthalmic examination during this period at King Abdulaziz Medical City in Jeddah. Results: Eighty-one patients met the inclusion and exclusion criteria and had ophthalmic examinations. Forty-three (53.1%) patients were males, and 38 (46.9%) patients were females. Acute lymphocytic leukemia (ALL) was diagnosed in 55 (67.9%) patients, while acute myelogenous leukemia (AML) was diagnosed only in 26 (32.1%). Ophthalmic manifestations were observed in 23 patients with a prevalence of 28.4%. AML patients had more manifestations with a rate of 38.5%. ALL had a rate of 23.6% (p=0.1). Retinal hemorrhage was the most commonly seen manifestation in six patients. Conclusion: Ophthalmic manifestations are not uncommon in acute leukemia patients. Low hemoglobin and RBC could give an idea about the type of ophthalmic manifestation, not the presence or absence. It is highly recommended to examine acute leukemia patients routinely prior, during, and after the treatment to prevent serious ocular damage and monitor the course of the disease.

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Section: Discussionmentioning

confidence: 99%

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

Bukhari¹,

Alzahrani²,

Alqarni³

et al. 2021

Cureus

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“…Ocular involvement in leukemia is considered rare 3,4 . Liebreich was the first to describe leukemic retinopathy in the 1860s.…”

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confidence: 99%

“…Intraocular leukemic involvement most frequently presents in the posterior segment. Hemorrhages in the retina are the most prevalent feature of leukemia 4,7 . Some forms of hemorrhages representing leukemic cell infiltration while others forms of hemorrhages in leukemic patients are secondary to the systemic conditions.…”

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confidence: 99%

Ocular Manifestations of Leukemia and Results of Treatment with Intravitreal Methotrexate

Dai

King

Lekach

et al. 2020

Sci Rep

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ocular involvement in leukemia is considered rare. ocular symptoms can be the presenting signs of leukemia, they can appear after diagnosis has been established, or they can be the first manifestation of a relapse after remission. We report, to the best of our knowledge for the first time, the ocular manifestation of a series of patients with ocular leukemia and the result of their treatment with intravitreal methotrexate (MtX) injections. this is a retrospective cohort study. the medical records of 12 consecutive patients with ocular leukemia (24 eyes, 11 eyes treated with MTX) treated at the Sheba Medical Center from January 2010 to December 2017 were retrospectively reviewed. Details on ocular inflammatory reaction and tumor cell infiltration at presentation and the end of follow-up were recorded as main outcome measures. The 12 patients included 7 women and 5 men (mean age ± standard deviation at diagnosis 25.92 ± 23.91 years, range 2-82 years). Eleven eyes of 6 patients were treated with intravitreal MTX injections. The indication for treatment was biopsy proven, tumor cell infiltration. The mean number of MTX injections was 3.37 ± 5.35 (range 1-18). The mean follow-up was 27.08 ± 36.79 months (range 1-93). All treated eyes showed improvement in the inflammatory reaction and tumor cell infiltration. In conclusion we found that Intravitreal MTX injections may be an effective therapeutic approach for eyes with intraocular leukemic tumor cell infiltration.

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“…The purpose of the present study was to investigate the risk and clinical significance of steroid-induced ocular hypertension in children treated with systemic glucocorticoid. High-dose systemic glucocorticoid is crucial in the treatment of many life-threatening diseases in childhood and, as a consequence of the considerable improvement in long-term survival of many severe paediatric diseases, there is increasing need for data about the possible long-term ocular adverse effects of steroid such as glaucoma and cataract (Wheland et al 2010;de Queiroz Mendonca et al 2019).…”

Section: Discussionmentioning

confidence: 99%

Risk of ocular hypertension in children treated with systemic glucocorticoid

Krag

Larsen

Albertsen

et al. 2021

Acta Ophthalmologica

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Purpose: To investigate the risk of steroid-induced ocular hypertension in children treated with systemic glucocorticoid. Methods: Prospective cohort study of children treated with high-dose systemic glucocorticoid (prednisolone-equivalent >0.5 mg/kg/day) for more than 2 weeks. Intraocular pressure (IOP) was measured by an Icare tonometer. An intraocular hypertensive response was defined as a net increase in IOP ≥6 mmHg from baseline or a peak IOP ≥21 mmHg in either eye. Patients with a peak IOP ≥31 mmHg or a net increase in IOP ≥15 mmHg were considered as high responders.Results: Sixteen children with median age 12 years (range 5-17) were included in the study. Nine children (56%) developed a steroid-induced ocular hypertensive response. Two children (12%) were high responders with peak IOP between 32 and 44 mmHg and a net increase in IOP between 15 and 23 mmHg. All children were asymptomatic and IOP was normalized in all after withdrawal of steroid. Steroid responders were significantly younger than nonresponders (p = 0.03). No associations were found between net IOP increase and time to peak pressure, steroid dose at peak pressure or accumulated prednisolone dose at peak IOP. Conclusion: Systemic treatment of children with glucocorticoid can cause a significant increase in IOP which indicates the need for IOP screening of these children. The risk of steroid-induced ocular hypertension may depend on age and ethnicity. In this perspective, further studies on Caucasian children are needed.

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Ocular manifestations in acute lymphoblastic leukemia: A five-year cohort study of pediatric patients

Cited by 26 publications

References 19 publications

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

Ocular Manifestations of Leukemia and Results of Treatment with Intravitreal Methotrexate

Risk of ocular hypertension in children treated with systemic glucocorticoid

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