Ocular manifestations of childhood acute leukemia in a tertiiary level eye centre of Kathmandu, Nepal

Khadka, Deepak; Sharma, Ananda Kumar; Shrestha, Junu; Shrestha, Prabin; Pant, Suresh Raj; Pant, Bidya Prasad

doi:10.3126/nepjoph.v6i2.11678

Cited by 17 publications

(18 citation statements)

References 21 publications

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“…In the current study, ophthalmic manifestations were present in 48.5% of patients with acute leukemia. The frequency of ocular signs in acute leukemia was similar to the studies of Koshy et al (51.9%) [10], Khadka et al (46%) [4], Gawai et al (52.23%) [5], and Dhasmana et al (45.1%) [7]. On the other hand, it was significantly less than those reported in the study of Eze et al (72.7%) [8].…”

Section: Discussionsupporting

confidence: 85%

“…Ophthalmic manifestations were more commonly seen as a consequence of secondary changes in systemic leukemia (83.3%) as compared to the direct ocular involvement in acute leukemia (16.7%). These findings were statistically significant and supported by the studies of Koshy et al [10], Khadka et al [4], Gawai et al [5], and Eze et al [8].…”

Section: Discussionsupporting

confidence: 80%

“…Ocular involvement in leukemia may occur due to direct leukemic infiltration or because of secondary ophthalmic involvement as a result of abnormalities related to blood like anemia, thrombocytopenia, and leukocytosis or because of chemotherapy or immunosuppression [4]. Direct leukemic infiltration can involve orbit, anterior segment, uvea, and the optic nerve.…”

Section: Introductionmentioning

confidence: 99%

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Ophthalmic Manifestations of Acute Leukemia

Hafeez

Ali

Najib

et al. 2019

Cureus

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IntroductionOcular involvement in leukemia may occur because of direct leukemic infiltration or because of secondary ophthalmic involvement as a result of abnormalities related to blood like anemia, thrombocytopenia, and leukocytosis. In some patients with leukemia, ophthalmic signs can precede the systemic features and can help in early diagnosis of systemic leukemia. Due to the scarcity of data on this topic from Pakistan, we conducted this study to determine the pattern of ocular involvement in patients with leukemia presenting in our settings.MethodsThis cross-sectional study was conducted in a tertiary care hospital of Pakistan over a period of one year. The study comprised of both newly diagnosed and follow-up patients of acute leukemia of age more than 15 years. Patients underwent detailed ophthalmic anterior and dilated posterior segment examination. Patient’s demographic profile, type of leukemia, chemotherapy status, and hematologic findings were also documented.ResultsThere were 97 leukemic patients in the study with 55 (56.7%) males and 42 (43.3%) females. Various ophthalmic manifestations were observed in 47 (48.45%) patients. Forty-two (43.3%) were diagnosed cases with acute lymphocytic leukemia (ALL) and 55 (56.7%) suffered from acute myelogenous leukemia (AML). Ophthalmic manifestations were present in 29 patients of AML (52.7%) and 18 patients of ALL (42.85%). Ocular involvement was significantly more common in newly diagnosed (n=32) as compared with follow-up patients (n=15) (p-value = 0.032). Posterior segment (n=48) was the most common site of ocular involvement (n=48, 49.5%) with retinal hemorrhages seen in 40 patients (41.2%) and papilloedema in seven cases (7.2%). Thirty-three (70.2%) out of 47 patients with ophthalmic manifestations were asymptomatic while 14 (29.8%) had ocular symptoms at the time of initial presentation.ConclusionOphthalmic manifestations were present in about half of the patients with leukemia. Ocular involvement was more prevalent in newly diagnosed cases and in patients with AML.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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Ophthalmic Manifestations of Acute Leukemia

Hafeez

Ali

Najib

et al. 2019

Cureus

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“…In large-scale surveys conducted in the past on acute myeloid leukemia, acute lymphatic leukemia, and chronic myeloid leukemia (Gordon et al, 2001; Russo et al, 2008; Khadka et al, 2014), the rate of ocular infiltration was not particularly high. In this survey, on the other hand, approximately half of the cases of ATL ocular lesions involved ocular infiltration.…”

Section: Discussionmentioning

confidence: 98%

Adult T-Cell Leukemia/Lymphoma-Related Ocular Manifestations: Analysis of the First Large-Scale Nationwide Survey

et al. 2019

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Adult T-cell leukemia/lymphoma (ATL) is a rare and aggressive T-cell malignancy with a high mortality rate, resulting in a lack of information among ophthalmologists. Here, we investigated the state of ophthalmic medical care for ATL and ATL-related ocular manifestations by conducting the first large-scale nationwide survey in Japan. A total of 115 facilities were surveyed, including all university hospitals in Japan that were members of the Japanese Ophthalmological Society and regional core facilities that were members of the Japanese Ocular Inflammation Society. The collected nationwide data on the state of medical care for ATL-related ocular manifestations and ATL-associated ocular findings were categorized, tallied, and analyzed. Of the 115 facilities, 69 (60%) responded. Overall, 28 facilities (43.0%) had experience in providing ophthalmic care to ATL patients. ATL-related ocular manifestations were most commonly diagnosed “based on blood tests and characteristic ophthalmic findings.” By analyzing the 48 reported cases of ATL-related ocular manifestations, common ATL-related ocular lesions were intraocular infiltration (22 cases, 45.8%) and opportunistic infections (19 cases, 39.6%). All cases of opportunistic infection were cytomegalovirus retinitis. Dry eye (3 cases, 6.3%), scleritis (2 cases, 4.2%), uveitis (1 case, 2.1%), and anemic retinopathy (1 case, 2.1%) were also seen. In conclusion, intraocular infiltration and cytomegalovirus retinitis are common among ATL patients, and ophthalmologists should keep these findings in mind in their practice.

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“…Ophthalmic manifestations have been reported in the literature with different prevalence from study to study, ranging from 24% to 70% [4,[8][9][10][13][14][15][16][17]. Also, some studies that have been done in Saudi Arabia reported prevalence ranging from 35%-54%; however, these studies are old and published in the '90s [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

Bukhari¹,

Alzahrani²,

Alqarni³

et al. 2021

Cureus

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Background: Leukemia is a neoplastic disorder that affects blood and bone marrow and is characterized by white blood cells' abnormal proliferation. Leukemia patients may present with different ophthalmic manifestations. This study aims to provide an updated data about the prevalence and types of ocular manifestations in acute leukemia patients and their relation with the hematological parameters. Methods: This retrospective cross-sectional study included all acute leukemia patients diagnosed from 2015 to 2020 and underwent an ophthalmic examination during this period at King Abdulaziz Medical City in Jeddah. Results: Eighty-one patients met the inclusion and exclusion criteria and had ophthalmic examinations. Forty-three (53.1%) patients were males, and 38 (46.9%) patients were females. Acute lymphocytic leukemia (ALL) was diagnosed in 55 (67.9%) patients, while acute myelogenous leukemia (AML) was diagnosed only in 26 (32.1%). Ophthalmic manifestations were observed in 23 patients with a prevalence of 28.4%. AML patients had more manifestations with a rate of 38.5%. ALL had a rate of 23.6% (p=0.1). Retinal hemorrhage was the most commonly seen manifestation in six patients. Conclusion: Ophthalmic manifestations are not uncommon in acute leukemia patients. Low hemoglobin and RBC could give an idea about the type of ophthalmic manifestation, not the presence or absence. It is highly recommended to examine acute leukemia patients routinely prior, during, and after the treatment to prevent serious ocular damage and monitor the course of the disease.

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Ocular manifestations of childhood acute leukemia in a tertiiary level eye centre of Kathmandu, Nepal

Cited by 17 publications

References 21 publications

Ophthalmic Manifestations of Acute Leukemia

Ophthalmic Manifestations of Acute Leukemia

Adult T-Cell Leukemia/Lymphoma-Related Ocular Manifestations: Analysis of the First Large-Scale Nationwide Survey

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center

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