OCULAR MANIFESTATIONS IN ACUTE LEUKEMIA: A COMPREHENSIVE ANALYSIS OF RETINAL CHANGES AND CLINICAL CORRELATIONS

Abstract

Background: Acute leukemia represents a heterogeneous group of hematologic malignancies with significant potential for ocular involvement. The eye serves as a unique window for direct visualization of leukemic manifestations, potentially providing crucial diagnostic and prognostic information.

Objective: This study aimed to comprehensively evaluate the prevalence, patterns, and clinical significance of retinal changes in patients diagnosed with acute leukemia, while establishing correlations with hematologic parameters and disease characteristics.

Methods: A prospective cross-sectional study was conducted at Baghdad Teaching Hospital/Medical City Complex from November 2015 to May 2016. Fifty-three patients (≥14 years) with confirmed acute leukemia (30 AML, 23 ALL) underwent comprehensive ophthalmologic evaluation including dilated fundoscopy, visual acuity assessment, and intraocular pressure measurement. Statistical analysis employed SPSS v.21 with significance set at p<0.05.

Results: Retinal abnormalities were identified in 22 patients (41.5%), with comparable prevalence between AML (40.0%) and ALL (43.5%). The most frequent manifestation was intraretinal hemorrhage (34.0%), followed by Roth spots (22.6%) and cotton-wool spots (15.1%). Less common findings included subhyaloid hemorrhage (5.7%), vitreous hemorrhage (3.8%), and optic disc swelling (1.9%). No significant associations were found between retinopathy presence and patient gender, age, or leukemia subtype (p>0.05).

Conclusions: Retinal manifestations occur in approximately two-fifths of acute leukemia patients, with intraretinal hemorrhage representing the predominant finding. These results support the implementation of routine ophthalmologic screening in acute leukemia management protocols.