OPHTHALMIC MANIFESTATIONS OF LEUKEMIA

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Abstract

Ophthalmic manifestations of leukemia are variable and are predominantly represented by leukemic infiltration of the eye and hemodynamic abnormalities in the retinal vasculature. Leukemic infiltration of the retina should be differentiated from an inflammatory process, such as retinitis, chorioretinitis of viral or fungal origin that are not uncommon in patients with hematological malignancies. Retinal involvement is mainly seen in adult patients with acute myeloid leukemia and is less common in patients with acute lymphoblastic leukemia. Retinopathy is more frequent during relapses of the underlying disease. Also, retinopathy can be the first sign of the disease. Leukemia should be included into the list for differential diagnosis with disorders that can be associated with optical nerve edema and retinal hemorrhages. Fundus abnormalities correlate with peripheral blood parameters. Retinopathy and leukemic optic neuropathy are predictors of unfavorable prognosis. Early diagnostics and timely and adequate treatment may fully eliminate ocular symptoms and improve quality of life in patients with hemoblastoses.

About the authors

E. E. Grishina

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Author for correspondence.
Email: eyelena@mail.ru
MD, PhD, Professor, Leading Research Fellow, Department of Ophthalmology Россия

A. O. Mamontov

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: eyelena@mail.ru
MD, Postgraduate Student Россия

References

  1. Волкова МА, ред. Клиническая онкогематология. 2-е изд. М.: Медицина; 2007. 1119 с.
  2. Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology. 2004;111(5): 997–1008. doi: 10.1016/j.ophtha.2003.01.002.
  3. Бровкина АФ. Болезни орбиты М.: Медицинское информационное агентство; 2008. 256 c.
  4. Гришина ЕЕ. Злокачественные лимфомы органа зрения. Проблемы и перспективы (взгляд офтальмолога). Современная онкология. 2006;8(4): 27–9.
  5. Bonavolontà G, Strianese D, Grassi P, Co-mune C, Tranfa F, Uccello G, Iuliano A. An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthal Plast Reconstr Surg. 2013;29(2): 79–86. doi: 10.1097/IOP.0b013e31827a7622.
  6. Jain VK, Singh U, Prakash G, Vashishta RK, Singh V. Rare primary presentation of chronic lymphocytic leukemia as chronic orbital space occupying lesion. Int J Ophthalmol. 2016;9(1): 173–4. doi: 10.18240/ijo.2016.01.30.
  7. Ramkissoon YD, Lee RW, Malik R, Hsuan JD, Potts MJ. Bilateral infiltrative disease of the extraocular muscles: a rare clinical presentation of early stage chronic lymphocytic leukemia. Orbit. 2008;27(4): 293–5. doi: 10.1080/01676830802222878.
  8. Hatton MP, Rubin PA. Chronic lymphocytic leukemia of the orbit. Arch Ophthalmol. 2002;120(7): 990–1.
  9. Гусева МР. Изменения органа зрения у детей при общих заболеваниях. РМЖ «Клиническая офтальмология». 2001;(4): 135.
  10. Reddy SC, Jackson N, Menon BS. Ocular involvement in leukemia – a study of 288 cases. Ophthalmologica. 2003;217(6): 441–5. doi: 73077.
  11. Abu el-Asrar AM, al-Momen AK, Kangave D, Harakati MS, Ajarim DS. Correlation of fundus lesions and hematologic findings in leukemic retinopathy. Eur J Ophthalmol. 1996;6(2): 167–72.
  12. Jackson N, Reddy SC, Hishamuddin M, Low HC. Retinal findings in adult leukaemia: correlation with leukocytosis. Clin Lab Haematol. 1996;18(2): 105–9. doi: 10.1046/j.1365-2257.1996.d01-217.x.
  13. Koshy J, John MJ, Thomas S, Kaur G, Batra N, Xavier WJ. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India. Indian J Ophthalmol. 2015;63(8): 659–64. doi: 10.4103/0301-4738.169789.
  14. Lin AL, Burnham JM, Pang V, Idowu O, Iyer S. Ocular manifestations of primary myelofibro-sis. Retin Cases Brief Rep. 2016;10(4): 364–7. doi: 10.1097/ICB.0000000000000264.
  15. Salazar Méndez R, Fonollá Gil M. Unilateral optic disk edema with central retinal artery and vein occlusions as the presenting signs of relapse in acute lymphoblastic leukemia. Arch Soc Esp Oftalmol. 2014;89(11): 454–8. doi: 10.1016/j.oftal.2013.10.011.
  16. Hara Y, Kamura Y, Oikawa A, Shichino H, Mugishima H, Goto H. Case of pediatric chronic myeloid leukemia with bilateral visual loss onset. Nippon Ganka Gakkai Zasshi. 2010;114(5): 459–63.
  17. Reddy SC, Menon BS. A prospective study of ocular manifestations in childhood acute leukaemia. Acta Ophthalmol Scand. 1998;76(6): 700–3. doi: 10.1034/j.1600-0420.1998.760614.x.
  18. Huang PK, Sanjay S. Visual disturbance as the first symptom of chronic myeloid leukemia. Middle East Afr J Ophthalmol. 2011;18(4): 336–8. doi: 10.4103/0974-9233.90143.
  19. Nagpal MP, Mehrotra NS, Mehta RC, Shukla CK. Leukemic optic nerve infiltration in a patient with acute lymphoblastic leukemia. Retin Cases Brief Rep. 2016;10(2): 127–30. doi: 10.1097/ICB.0000000000000187.
  20. Fardeau C, Lee CP, Merle-Béral H, Cassoux N, Bodaghi B, Davi F, Lehoang P. Retinal fluorescein, indocyanine green angiography, and optic coherence tomography in non-Hodgkin primary intraocular lymphoma. Am J Ophthalmol. 2009;147(5): 886–94, 894.e1. doi: 10.1016/j.ajo.2008.12.025.
  21. Gordon KB, Rugo HS, Duncan JL, Irvine AR, Howes EL Jr, O'Brien JM, Carter SR. Ocular manifestations of leukemia: leukemic infiltration versus infectious process. Ophthalmology. 2001;108(12): 2293–300.
  22. Gupta SR, Agnani S, Tehrani S, Yeh S, Lauer AK, Suhler EB. Endogenous Streptococcus agalactiae (Group B Streptococcus) endophthalmitis as a presenting sign of precursor T-cell lymphoblastic leukemia. Arch Ophthalmol. 2010;128(3): 384–5. doi: 10.1001/archophthalmol.2009.397.
  23. Dave VP, Majji AB, Suma N, Pappuru RR. A rare case of Aspergillus terreus endogenous en-dophthalmitis in a patient of acute lymphoid leukemia with good clinical outcome. Eye (Lond). 2011;25(8): 1094–6. doi: 10.1038/ eye.2011.68.
  24. Гришина ЕЕ, Агеенкова ОА. Воспалительные заболевания глаз у больных гемобластозами. РМЖ «Клиническая офтальмология». 2006;(1): 10–1.
  25. Huynh TH, Johnson MW, Hackel RE. Bilateral proliferative retinopathy in chronic myeloge-nous leukemia. Retina. 2007;27(1): 124–5. doi: 10.1097/01.iae.0000258271.36131.d3.
  26. Mandava N, Costakos D, Bartlett HM. Chronic myelogenous leukemia manifested as bilateral proliferative retinopathy. Arch Ophthalmol. 2005;123(4): 576–7. doi: 10.1001/ archopht.123.4.576.
  27. Nobacht S, Vandoninck KF, Deutman AF, Klevering BJ. Peripheral retinal nonperfusion associated with chronic myeloid leukemia. Am J Ophthalmol. 2003;135(3): 404–6. doi: http:// dx.doi.org/10.1016/S0002-9394(02)01956-6.
  28. Chen MT, Wu HJ. Acute leukemia presenting as diabetes insipidus and bilateral exudative retinal detachment – a case report. Kaohsiung J Med Sci. 2001;17(3): 150–5.
  29. Fackler TK, Bearelly S, Odom T, Fekrat S, Cooney MJ. Acute lymphoblastic leukemia presenting as bilateral serous macular detachments. Retina. 2006;26(6): 710–2. doi: 10.1097/01.iae.0000236484.24808.bb.
  30. Kincaid MC, Green WR, Kelley JS. Acute ocular leukemia. Am J Ophthalmol. 1979;87(5): 698– 702.
  31. Malik R, Shah A, Greaney MJ, Dick AD. Bilateral serous macular detachment as a presenting feature of acute lymphoblastic leukemia. Eur J Ophthalmol. 2005;15(2): 284–6.
  32. Leonardy NJ, Rupani M, Dent G, Klintworth GK. Analysis of 135 autopsy eyes for ocular involvement in leukemia. Am J Ophthalmol. 1990;109(4): 436–44.
  33. Gaudric A, Sterkers M, Coscas G. Retinal detachment after choroidal ischemia. Am J Ophthalmol. 1987;104(4): 364–72.
  34. Spaide RF, Goldbaum M, Wong DW, Tang KC, Iida T. Serous detachment of the retina. Retina. 2003;23(6): 820–46.
  35. Reddy SC, Quah SH, Low HC, Jackson N. Prognostic significance of retinopathy at presentation in adult acute leukemia. Ann Hematol. 1998;76(1): 15–8.
  36. Abu el-Asrar AM, al-Momen AK, Kangave D, Harakati MS. Prognostic importance of retinopathy in acute leukemia. Doc Ophthalmol. 1995–1996;91(3): 273–81.
  37. Reddy SC, Jackson N. Retinopathy in acute leukaemia at initial diagnosis: correlation of fun-dus lesions and haematological parameters. Acta Ophthalmol Scand. 2004;82(1): 81–5. doi: 10.1046/j.1600-0420.2003.00197.x.
  38. Abdul-Rahim AS, Brown SM, Shami MJ. Bilateral retinal hemorrhages in an 18-year-old woman. Surv Ophthalmol. 2002;47(6): 590–3. doi: http://dx.doi.org/10.1016/S0039-6257(02)00352-1.
  39. Mandić BD, Potocnjak V, Bencić G, Mandić Z, Pentz A, Hajnzić TF. Visual loss as initial presentation of chronic myelogenous leukemia. Coll Antropol. 2005;29 Suppl 1:141–3.
  40. Ortiz JM, Ruiz-Moreno JM, Pozo-Martos P, Montero JA. Visual acuity loss and OCT changes as initial signs of leukaemia. Int J Ophthalmol. 2010;3(3): 281–2. doi: 10.3980/j.issn.2222-3959.2010.03.24.

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Copyright (c) 2016 Grishina E.E., Mamontov A.O.

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