Ophthalmic manifestations of leukemia and their association with hematologic parameters among adult patients in Jos, Nigeria

Abstract

Objective: To determine the prevalence and pattern of ophthalmopathy in patients with leukemia, and their relationship with hematological parameters.

Patients and Methods: A cross sectional study of consecutive adult patients diagnosed with any leukemia, confirmed by bone marrow biopsy in two referral hospitals in Jos. Data was collected between January 2016 and June 2017. Sociodemographic and medical history were obtained from patients who consented to participate in the study. Results of the most recent hematologic parameters were retrieved from patient's case notes. Comprehensive ocular examination, including dilated fundoscopy was conducted and findings noted. Data was analysed using Statistical Package for Social Sciences version 21.

Results: Sixty-nine patients were examined during the study period. Their mean age was 44±18.8 years with a male to female ratio of 1.9:1. Forty-four (63.8%) participants had ocular manifestations. Leukemia specific manifestations were largely in the posterior segment (50.8%) and include tortuous retinal vessels (11.9%), retinal hemorrhage (10.2%), maculopathy (8.5%), disc swelling (5.9%) and cotton wool spots (5.1%). Non-leukemia specific manifestations such as cataract, pseudophakia and glaucoma accounted for 33.3% of findings. Significant predictors for occurrence of ocular manifestations were hemoglobin concentration (P=0.042) and platelet count (P=0.006). Increasing hemoglobin concentration may reduce the likelihood of developing retinal hemorrhage in 43.5% of cases (p= 0.007).

Conclusions: Ocular manifestations of leukemia were predominantly in the posterior segment and frequently associated with anaemia and thrombocytopenia.