Title: Ocular manifestations in adult leukemia patients in a tertiary centre: A cross sectional study
Authors: Dr Swathi Karuppali, Dr Arun Kumar Ayoor, Dr Abdul Majeed K., Dr Padma B Prabhu
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.85
Abstract
Background: Leukemias are clonal neoplastic disorders of the hematopoetic stem cells in which immature cells infiltrate the blood stream and various tissues of the body. Eye is one such structure which is commonly involved either primarily by direct infiltration by leukemic cells or secondary to changes in the haematological parameters. Hence detailed ocular examination should be an essential part of treatment of leukemias to identify early changes.
Objectives: To study the various ocular manifestations in adult leukemia patients.
Methods: A cross sectional descriptive study was conducted among 200 eyes of 100 diagnosed leukemia patients who presented to hematology and ophthalmology department of Government Medical College Kozhikode. The patients were divided into various types of leukemia and detailed ocular examination was conducted. The anterior and posterior segment manifestations in each type of leukemias were noted .The observed findings were analysed using SPSS version 16.
Results and Discussion: Out of the 100 patients, there were 47 males and 53 females. The mean age of the study group was 38.35±19.83 years. Acute myeloid leukemia was the commonest type (51%). 61%of the patients were symptomatic with defective vision being the commonest followed by watering as their chief complaints. Anterior segment manifestations were present in 76% patients with conjunctival congestion followed by pallor being the commonest. Posterior segment involvement was noted in 34% patients of which majority had retinal haemorrhages followed by papilledema and optic disc cupping. These findings were more in the myeloid group who again had poorer visual acuity .Some patients developed drug related complications for which further detailed evaluation is needed to confirm the same in view of the multidrug regimens on which these patients are on.
Conclusion: High prevalence of ocular manifestations in the leukemic patients can be a cause of ocular morbidity and vision loss in these subjects. These findings may also be an early indicator of relapse .Hence regular ophthalmic assessment and early diagnosis can improve the disease outcome.
Keywords: Leukemia; ocular manifestations; retinal hemorrhage.