Ocular fundus involvement and visual outcome of leukemia patients: Our experience in a Tertiary Hospital population of North India

• Author Details:   
• Priyadarshini Mishra
• Vikas Kanaujia
• Kumudini Sharma
• Alka Tripathi
• Rachna Agarwal

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Aims: To study the posterior segment involvement pattern and visual outcome of leukemia patients in a tertiary care hospital population of north India.
Materials and Methods: This is a prospective, observational case series study from a single centre. All leukemia patients coming to Ophthalmology department for routine check-up were screened. Those who had fundus involvement were included in the study after other retinal diseases ruled out. Detailed ophthalmological examination done. Investigations like Optical coherence tomography, B scan ultrasonography, fundus fluorescein angiography done when required. Various posterior segment ophthalmic manifestations were analysed. Ophthalmologic intervention done when required and all patients followed up for at least 6 months and visual outcome noted.
Results: There were 41 leukemia patients with fundus involvement (30 males and 11 females), age range 5 years to 60 years. The posterior segment findings was retinal venous tortuosity and stasis, haemorrhages, Roth spots, serous retinal detachment, optic nerve infiltration, papilledema, proliferative changes. At presentation 22 patints with leukemic retinopathy (53.6 %) had normal vision, 10 (24.4%) visual impairment and 9 (22%) had blindness. At 6 months 34 patients (82.92%) had normal vision, 5 (12.2%) had visual impairment and 2 (4.9%) remained blind. Visual improvement in normal and blind group was statistically significant (p<0.05)
Conclusion: Leukemic retinopathy responds well to modern chemotherapy. Optic nerve infiltration require prompt intervention, still has poor visual prognosis. Regular ophthalmological examinations are recommended in all leukemia patients to help in identifying relapses and optimize treatment outcome

Keywords: Leukemia, Leukemic retinopathy, Visual prognosis.