Annals of African Medicine
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ORIGINAL ARTICLE
Year : 2016  |  Volume : 15  |  Issue : 3  |  Page : 97-103

Ocular manifestations in leukemia and myeloproliferative disorders and their association with hematological parameters


1 Department of Ophthalmology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
2 Department of Medicine, Swami Rama Himalayan University, Dehradun, Uttarakhand, India

Correspondence Address:
Amrita Prakash
Department of Ophthalmology, Swami Rama Himalayan University, Dehradun - 248 001, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-3519.188887

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Objectives: To study the ocular manifestations in patients diagnosed with leukemia or myeloproliferative disorders and to derive an association between the ocular manifestations and hematological parameters of the patients. Materials and Methods: This observational and descriptive study was conducted in a Tertiary Care Center of Dehradun, North India over a period of 1 year. All the diagnosed cases of leukemia and myeloproliferative diseases attending the Oncology Department were included. Patients underwent a detailed ocular examination. The hematological parameters were also recorded including hemoglobin (Hb), total leukocyte count (TLC), and platelet count. Results: The study included 102 patients out of which, there were 66 males (64.7%), and 36 were females (35.3%) with an age range of 5-80 years. A total of forty patients showed ocular manifestations (39.3%). Extraocular manifestations were seen in 10.8% patients while intraocular manifestations were noted in 45.1% patients of acute leukemia and 7.7% patients of chronic leukemia. These ocular manifestations showed a significant association with low Hb (P = 0.000), raised TLC (P = 0.004), and low platelet count (P = 0.000). The most common ocular manifestation was intraretinal hemorrhages followed by roth spots. Among acute myeloid leukemia patients (23.5%), the presence of intraretinal hemorrhages was significantly associated with low Hb (Mann-Whitney U-test = 25.000, P = 0.007). The patients of acute lymphoblastic leukemia (25.4%) showed significant association between intraretinal hemorrhages and low platelet count (Mann-Whitney U-test = 44.000, P = 0.046) and roth spots with low Hb (Mann-Whitney U-test = 11.000, P = 0.000). Ocular manifestations were more commonly seen in acute leukemias as compared to chronic leukemias. Conclusion: Ocular examination is recommended in all leukemic patients as ocular manifestations may go unnoticed, most patients being asymptomatic and could be an early sign of worsening of disease.


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