Ophthalmic Manifestations In Patients of Acute Leukaemia Presenting to A Tertiary Care Centre In Western Rajasthan

Abstract

Purpose:- To determine the prevalence and pattern of ophthalmic manifestations in patients of Acute Myeloid Leukemia (AML) and Acute Lymphoid Leukemia (ALL) presenting to a tertiary care centre in Western Rajasthan. Materials and Methods:- This cross-sectional non-interventional study was conducted from April 2015 to March 2016 to study the spectrum of ophthalmic manifestations in 110 acute leukaemia patients. Patient’s demographic data, medical and treatment history, anterior and posterior segment examination with haematological and radiological investigations were recorded. Results:- The study subjects (n = 110: 57 males and 53 females) comprised 64 ALL and 46 AML patients whose age ranged from 22 months to 58 years. There were 44 adults and 66 children. Leukemic ophthalmopathy was present in 61 (55.45%) subjects. Ocular changes were present in 30/44 (68.18%) adults and 31/66 (46.97%) children (P<0.04). Thirty four males (34/57, 59.65%) and 27/53 (50.94%) females had ocular manifestations (P<0.46). The leading posterior segment ophthalmic manifestation was superficial haemorrhage and the anterior segment manifestation was sub-conjunctival hemorrhage. Primary or direct leukemic infiltration was seen in 11 (10%) subjects while secondary or indirect involvement was seen in 60 (54.54%) subjects. Leukemic ophthalmopathy was more prevalent in Acute Myeloid Leukaemia in comparison to Acute Lymphoid Leukaemia, frequently affected the ocular posterior segment and often resulted from secondary hematologic complications (P <0.001). Conclusion:- Leukemic ophthalmic lesions were found in 61/110 (55.45%) patients. Ocular involvement is more often seen in Acute Myeloid Leukemia. Early diagnosis and regular ophthalmic examinations are recommended to optimize diagnosis, prognostic and treatment outcomes of Acute Leukaemia patients.