Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India

ABSTRACT: Background: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. This study looks at the spectrum of ocular manifestations in acute and chronic leukemias, presenting...

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Main Authors: Jacob Koshy, M Joseph John, Thomas Mathew, Satish Thomas, Gurvinder Kaur, S M Bhatti
Format: Article
Language:English
Published: PAGEPress Publications 2014-08-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
Subjects:
Online Access:https://mjhid.org/index.php/mjhid/article/view/1755
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author Jacob Koshy
M Joseph John
Thomas Mathew
Satish Thomas
Gurvinder Kaur
S M Bhatti
author_facet Jacob Koshy
M Joseph John
Thomas Mathew
Satish Thomas
Gurvinder Kaur
S M Bhatti
author_sort Jacob Koshy
collection DOAJ
description ABSTRACT: Background: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. This study looks at the spectrum of ocular manifestations in acute and chronic leukemias, presenting to a tertiary centre in India. Methods: A prospective cross-sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. Results: The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ± 22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (chi square 5.647 p value 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8. 3%) patients while secondary or indirect involvement due to anaemia, thrombocytopenia, hyperviscosity, total body irradiation and immunosupression were seen in 42 (43.8%) patients. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children ( p value 0.09460). Twenty - eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (p value 0.2874). The ocular manifestations were significantly (chi square 5.157 p value 0.01158) more frequent in myeloid leukaemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%) leukemias. Conclusions: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular changes are picked up in asymptomatic patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. KEYWORDS: Leukemia, Ophthalmic Manifestations, Retinopathy, Retinal haemorrhages.
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spelling doaj-art-24c8f58bdba84b11bc5d06f1d9a5fd9f2025-01-02T08:52:45ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-08-011Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in IndiaJacob Koshy0M Joseph John1Thomas Mathew2Satish Thomas3Gurvinder Kaur4S M Bhatti5Christian Medical College, Ludhiana, Punjab, IndiaChristian Medical College, Ludhiana, Punjab, IndiaChristian Medical College, Ludhiana, Punjab, IndiaChristian Medical College, Ludhiana, Punjab, IndiaChristian Medical College, Ludhiana, Punjab, IndiaChristian Medical College, Ludhiana, Punjab, IndiaABSTRACT: Background: Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. This study looks at the spectrum of ocular manifestations in acute and chronic leukemias, presenting to a tertiary centre in India. Methods: A prospective cross-sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. Results: The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ± 22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (chi square 5.647 p value 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8. 3%) patients while secondary or indirect involvement due to anaemia, thrombocytopenia, hyperviscosity, total body irradiation and immunosupression were seen in 42 (43.8%) patients. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children ( p value 0.09460). Twenty - eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (p value 0.2874). The ocular manifestations were significantly (chi square 5.157 p value 0.01158) more frequent in myeloid leukaemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%) leukemias. Conclusions: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular changes are picked up in asymptomatic patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. KEYWORDS: Leukemia, Ophthalmic Manifestations, Retinopathy, Retinal haemorrhages.https://mjhid.org/index.php/mjhid/article/view/1755LeukemiaOphthalmic ManifestationsRetinopathyRetinal haemorrhages.
spellingShingle Jacob Koshy
M Joseph John
Thomas Mathew
Satish Thomas
Gurvinder Kaur
S M Bhatti
Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
Mediterranean Journal of Hematology and Infectious Diseases
Leukemia
Ophthalmic Manifestations
Retinopathy
Retinal haemorrhages.
title Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
title_full Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
title_fullStr Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
title_full_unstemmed Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
title_short Ophthalmic Manifestations of Acute and Chronic Leukemias in a tertiary center in India
title_sort ophthalmic manifestations of acute and chronic leukemias in a tertiary center in india
topic Leukemia
Ophthalmic Manifestations
Retinopathy
Retinal haemorrhages.
url https://mjhid.org/index.php/mjhid/article/view/1755
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