Changes in retinal circulation and choroidal thickness in patients with acute myeloid leukemia detected by optical coherence tomography angiography

Yang, Ling; Chen, Yanwei; Zhang, Yunxiang; Shen, Ting; Shen, Xiaoye

doi:10.3389/fmed.2023.1117204

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Analyzing the general connection of D-dimer level with ophthalmic pathology in general, we can note the following correlations: the level of D-dimer is statistically significantly higher in patients with proliferative diabetic retinopathy than in patients with non-proliferative diabetic retinopathy [38,39]. Also, a statistically higher level of D-dimer was found in patients with leukemic retinopathy compared to the control group [40].…”

Section: Discussionmentioning

confidence: 87%

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Hutsaliuk,

Skalska,

Ulianova

2024

CSO

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Aims: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal chan- ges, according to funduscopy data in patients with different clinical courses of COVID-19. Materials and methods: 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical). Results: As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal chan- ges occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05). Conclusions: The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.

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Section: Discussionmentioning

confidence: 87%

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Hutsaliuk,

Skalska,

Ulianova

2024

CSO

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“…Leukemic retinopathy is the term most often used to denote the fundus manifestations of anaemia, thrombocytopenia and hyperviscosity observed in patients with leukaemia [12] . Experts believe that leukemic retinopathy is associated with abnormal hematologic parameters and coagulopathy [13,14] . Our patient presented with bilateral retinal vein dilatation and tortuosity, blot and ame-shaped retinal hemorrhages, and serous retinal detachment, features that were the result of both direct retinal leukemic in ltration and leukostasis secondary to hyperleukocytosis [15] .…”

Section: Discussionmentioning

confidence: 99%

Bilateral optic nerve infiltration and leukemic retinopathy as initial signs of leukemia relapse with central nervous system involvement in an adult: A case report

Wang,

Zhu,

Wang

et al. 2024

Preprint

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Background: We describe a case in which bilateral optic nerve infiltration and leukemic retinopathy were the initial signs of disease relapse in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+-ALL) with central nervous system (CNS) involvement. Case presentation: A 65-year-old Asian female with Ph+-ALL in complete remission presented at our institution with symptoms of visual disturbance, central scotoma and pain with eye movement in both eyes for a 1-month duration. Ophthalmic examination revealed remarkable optic disc swelling with multiple flame-shaped peripapillary hemorrhages, retinal venous dilation and retinal hemorrhages in both eyes. She was subsequently referred to the treating oncologist and diagnosed with Ph+-ALL relapse with multiple relapsed diseases involving the bone marrow and CNS. After intrathecal (IT) therapy, her visual acuity dramatically improved, and her leukemic infiltrates decreased. Conclusions: To the best of our knowledge, this is the first case report of ALL relapse with CNS involvement presenting as bilateral optic nerve infiltration and leukemic retinopathy in an adult. Hence, we highlight the priority and sensitivity of ophthalmic examinations, as they are noninvasive methods for detecting leukemia relapse.

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“…In particular, 5 µM 6TG significantly increased the cell viability of HUVECs exposed to high glucose and also reduced their vasculogenic activity, confirming its anti-angiogenic effects previously reported in endothelial cells or the chick embryo chorioallantoic membrane, as well as in AML patients showing a reduced bone marrow microvessel density when treated with 6TG ( Padró et al, 2000 ; Presta et al, 2002 ; Dean, 2012 ). It is worth noting that AML is frequently associated with severe retinal alterations characterized by retinal microvascular involvement, such as choroidal thickness and abnormalities in retinal circulation, known as leukemic retinopathy ( Yang et al, 2023 ). The anti-angiogenic effects of 6TG (1 and 2.5 mg/kg) were also shown in a DR mouse model by FA analysis, evidencing a reduction in retinal vascular alterations present in diabetic mice, such as irregular vessel caliber, vessel tortuosity and thinning, microaneurysm, or arteriovenous nicking.…”

Section: Discussionmentioning

confidence: 99%

Ocular pharmacological and biochemical profiles of 6-thioguanine: a drug repurposing study

Trotta,

Gesualdo,

Lepre

et al. 2024

Front. Pharmacol.

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Introduction:The purine analog 6-thioguanine (6TG), an old drug approved in the 60s to treat acute myeloid leukemia (AML), was tested in the diabetic retinopathy (DR) experimental in vivo setting along with a molecular modeling approach.Methods:A computational analysis was performed to investigate the interaction of 6TG with MC1R and MC5R. This was confirmed in human umbilical vein endothelial cells (HUVECs) exposed to high glucose (25 mM) for 24 h. Cell viability in HUVECs exposed to high glucose and treated with 6TG (0.05–0.5–5 µM) was performed. To assess tube formation, HUVECs were treated for 24 h with 6TG 5 µM and AGRP (0.5–1–5 µM) or PG20N (0.5–1–5–10 µM), which are MC1R and MC5R antagonists, respectively. For the in vivo DR setting, diabetes was induced in C57BL/6J mice through a single streptozotocin (STZ) injection. After 2, 6, and 10 weeks, diabetic and control mice received 6TG intravitreally (0.5–1–2.5 mg/kg) alone or in combination with AGRP or PG20N. Fluorescein angiography (FA) was performed after 4 and 14 weeks after the onset of diabetes. After 14 weeks, mice were euthanized, and immunohistochemical analysis was performed to assess retinal levels of CD34, a marker of endothelial progenitor cell formation during neo-angiogenesis.Results:The computational analysis evidenced a more stable binding of 6TG binding at MC5R than MC1R. This was confirmed by the tube formation assay in HUVECs exposed to high glucose. Indeed, the anti-angiogenic activity of 6TG was eradicated by a higher dose of the MC5R antagonist PG20N (10 µM) compared to the MC1R antagonist AGRP (5 µM). The retinal anti-angiogenic effect of 6TG was evident also in diabetic mice, showing a reduction in retinal vascular alterations by FA analysis. This effect was not observed in diabetic mice receiving 6TG in combination with AGRP or PG20N. Accordingly, retinal CD34 staining was reduced in diabetic mice treated with 6TG. Conversely, it was not decreased in diabetic mice receiving 6TG combined with AGRP or PG20N.Conclusion:6TG evidenced a marked anti-angiogenic activity in HUVECs exposed to high glucose and in mice with DR. This seems to be mediated by MC1R and MC5R retinal receptors.

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Changes in retinal circulation and choroidal thickness in patients with acute myeloid leukemia detected by optical coherence tomography angiography

Cited by 6 publications

References 32 publications

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

Bilateral optic nerve infiltration and leukemic retinopathy as initial signs of leukemia relapse with central nervous system involvement in an adult: A case report

Ocular pharmacological and biochemical profiles of 6-thioguanine: a drug repurposing study

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