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

Abstract

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.

Changes in retinal circulation and choroidal thickness in patients with acute myeloid leukemia detected by optical coherence tomography angiography

“…Nevertheless, PLT counts did not appear to be related. In previous research, some results were consistent with ours, but some differed ( 12 ). El-asrar et al found that patients with AML with Roth plaques had significantly higher WBC counts than did those without hemorrhage and that thrombocytopaenia was not associated with retinal hemorrhage ( 13 ).…”

Ocular Manifestations in Hematological Disorders

“…Immunosuppression caused by illness or its treatment, such as chemotherapy and bone marrow transplantation, can lead to opportunistic infections [6,7]. The overwhelming majority of patients with leukemia reported in our survey involved retinal hemorrhages (65%), similarly described in Bukhari et al retrospective cross-sectional study including 81 acute leukemia patients, with 60% of patients presenting ocular manifestations [8]. Male showed a greater predisposition, possibly due to the protective effect of estrogen in women against retinopathy [9].…”

Comment on: Ocular abnormalities at diagnosis and after the completion of treatment in children and adolescents with newly diagnosed acute lymphoblastic leukemia

“…4 This is consistent with the paper of Koshy et al 2 Very recently, Bukhari et al published their retrospective data on all included acute leukemia patients who underwent an ophthalmic examination during a period from 2015 to 2020. 5 They concluded that it is highly preferable to examine acute leukemia patients routinely before, during, and at the end of treatment to prevent serious ocular damage and to monitor the disease course.…”