Ocular Manifestations of Newly Diagnosed Acute Leukemia Patients

Reza Mirshahi; Fariba Ghassemi; Leili Koochakzadeh; Mohammad Faranoush; Zahra Ghomi; Azim Mehrvar; Seyed Asadollah Mousavi; Seyyed Reza Safaee Nodehi

doi:10.4103/joco.joco_10_21

Ocular Manifestations of Newly Diagnosed Acute Leukemia Patients

J Curr Ophthalmol. 2022 Apr 16;34(1):100-105. doi: 10.4103/joco.joco_10_21. eCollection 2022 Jan-Mar.

Authors

Reza Mirshahi¹, Fariba Ghassemi², Leili Koochakzadeh³, Mohammad Faranoush⁴, Zahra Ghomi⁵, Azim Mehrvar⁶, Seyed Asadollah Mousavi⁷, Seyyed Reza Safaee Nodehi⁸

Affiliations

¹ Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
² Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Pediatrics, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁵ Department of Radiology, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ MAHAK Hematology Oncology Research Center, MAHAK Hospital, Tehran, Iran.
⁷ Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Department of Hematology and Medical Oncology, Cancer Research Center, Cancer Institute of Iran, Imam Khomeini Hospital Complex, Tehran, Iran.

Abstract

Purpose: To present primary ocular manifestations in acute leukemia.

Methods: This cross-sectional descriptive hospital-based study evaluated all newly diagnosed leukemia patients of three referral hospitals of Tehran University of Medical Sciences in 2015-2016 and Mahak Hospital in Tehran in 2017. Exclusion criteria included the patients with the previous history of chemotherapy, cases of relapsing disease, and the patients with a history of ocular disease or other systemic conditions with ophthalmic manifestations.

Results: A total of 85 patients (170 eyes) were evaluated in our study, including 29 children (34.1%) and 43 females (50.6%). The mean patient age was 37.84 ± 11.91 years in the adult group and 6.28 ± 4.70 years in the pediatric category. Ophthalmic involvement was seen in 27 patients (31.8%), including 6 pediatric patients (20.7%) and 21 adult patients (37.5%). Two patients (2.3%) had direct infiltration by leukemic cells and 76 patients (89.41%) of patients were asymptomatic. There was a correlation between ophthalmic involvement and platelet count and hemoglobin level. In patients with ocular signs, higher mortality rates were observed.

Conclusions: At the time of diagnosis in acute leukemia patients, complete ophthalmic evaluation including dilated fundus examination is suggested as ocular involvement in these patients is common and sometimes asymptomatic. Ophthalmic involvement in leukemic patients should be identified in a timely manner, particularly in individuals with low platelet counts and hemoglobin levels, due to the potential prognostic relevance.

Keywords: Acute leukemia; Acute lymphoblastic leukemia; Acute myeloid leukemia; Leukemia; Ocular leukemic infiltration; Ophthalmic manifestation.