Ophthalmologic manifestations of acute leukemia are heterogeneous

Ophthalmologic manifestations of acute leukemia are heterogeneous and detectable at initial presentation or relapse, according to a study published online July 10 in the Annals of Hematology.

Dina N. Laimon, M.D., from Mansoura University in Egypt, and colleagues examined the incidence of different ophthalmological manifestations in newly diagnosed acute leukemia in a cross-sectional study involving 222 newly diagnosed acute myeloid and acute lymphoblastic leukemia patients (144 and 78, respectively) who presented between January 2022 and February 2023. All patients underwent a complete ophthalmic evaluation.

The researchers found that ophthalmic manifestations were detected in 43.2% of patients. Of these, 1.8% had poor visual acuity. The most common ocular manifestations were retinal hemorrhage and Roth spots (19.8 and 17.1%, respectively). Other ophthalmological manifestations included orbital involvement, ocular motility issues, subconjunctival hemorrhage, conjunctival chemosis, and lid swelling (3.2, 1.4, 5.9, 0.9, and 4.1%, respectively).

Compared with acute lymphoblastic leukemia patients, acute myeloid leukemia patients had a significantly higher frequency of ocular affection, retinal hemorrhages, and Roth spots. A significant association was seen for retinal hemorrhage with anemia.

“Cooperation between ophthalmologists and hemato-oncologists is crucial for recognizing ocular involvement and disease management,” the authors write. “We need further evaluation of a larger cohort of acute leukemia patients especially for survival analysis to set the record for the prognostic value of ocular manifestations in such neoplasms.”

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