Mediterranean Journal of Hematology and Infectious Diseases (Aug 2014)

Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India

  • Jacob Koshy,
  • M Joseph John,
  • Thomas Mathew,
  • Satish Thomas,
  • Gurvinder Kaur,
  • S M Bhatti

Journal volume & issue
Vol. 1

Abstract

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ABSTRACT: Background: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. This study looks at the spectrum of ocular manifestations in acute and chronic leukemias, presenting to a tertiary centre in India. Methods: A prospective cross-sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. Results: The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ± 22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (chi square 5.647 p value 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8. 3%) patients while secondary or indirect involvement due to anaemia, thrombocytopenia, hyperviscosity, total body irradiation and immunosupression were seen in 42 (43.8%) patients. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children ( p value 0.09460). Twenty - eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (p value 0.2874). The ocular manifestations were significantly (chi square 5.157 p value 0.01158) more frequent in myeloid leukaemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%) leukemias. Conclusions: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular changes are picked up in asymptomatic patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. KEYWORDS: Leukemia, Ophthalmic Manifestations, Retinopathy, Retinal haemorrhages.

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