Author: Jihene Sayadi (Tunisia)
Co-authors: Jihene Sayadi, Yasmine Allouche, Imen Malek, Leila Nacef
Purpose
The aim of our study was to determine the prevalence of ocular manifestations and their association with demographic, clinical and haematological parameters as well as to investigate whether ocular lesions are significant in predicting leukaemia prognosis.
Setting/Venue
Department of Haematology at Aziza Othmana University Hospital (Tunis, Tunisia) Department A of Ophthalmology, Hedi Rais Institute of Ophthalmology (Tunis, Tunisia).
Methods
Longitudinal, descriptive and analytic study was conducted over a period of ten months from December 2019 to September 2020. The study included newly diagnosed patients with acute leukaemia. A complete ophthalmic examination as well as a multimodal imaging were performed in all patients. Patient’s demographic profile, type of leukaemia and haematologic findings were also documented.
Results
Forty-six patients were examined during the study period. The mean age of patients was 32,1 years. Sex ratio was 1,55. Twenty-nine patients (63%) were diagnosed with acute myelogenous leukaemia (AML) and 17 (37%) suffered from acute lymphocytic leukaemia (ALL). Ophthalmic manifestations were seen in 28 patients (60,9%). Among them, 17 had vision-threatening complications (60,7%). Posterior segment was the most common site of ocular involvement (82,1%). Primary leukemic infiltration was seen in nine subjects (32,2%) while secondary lesions were identified in 24 subjects (85,7%). Other ocular manifestations as white-centred haemorrhages, cotton-wools and pigment epithelial detachments were seen in 17 patients (60,7%). Our study revealed significantly more frequent leukemic retinopathy in adults (p=0,003). Patients suffering from AML were more likely to have secondary ocular involvement (p=0,047). A significant association was noted between retinal haemorrhages and both anaemia (p=0,041) and thrombocytopenia (p=0,034). Moreover, patients with decreased visual acuity had a significantly lower haemoglobin level (p=0,003).
Conlusions
Leukemic ophthalmopathy is frequent. Due to its impact on the visual prognosis, a regular ophthalmological follow-up should be mandatory for all leukemic patients.
Financial Disclosure
The authors declare no conflict of interest.
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