The clinical characteristic of ocular findings secondary to hemophagocytic lymphohistiocytosis / 中国医师杂志

ABSTRACT

Objective:To describe the characterization of ocular changes secondary to hemophagocytic lymphohistiocytosis (HLH).Methods:The clinical data of 5 patients with HLH complicated with ocular involvement treated in Beijing Friendship Hospital Affiliated to Capital Medical University from September 2020 to May 2021 were retrospectively analyzed, the patients′ systemic examination and treatment were sorted out, and the ocular examination results were analyzed. The relevant literatures on ocular involvement of HLH patients were searched in China National Knowledge Infrastructure (CNKI), Pubmed, WOS, Embase and Medicine databases to summarize the characteristic manifestations of ocular involvement of HLH.Results:Of the 5 patients, 1 had primary HLH, 3 were Epstein-Barr virus-associated HLH (EBV-HLH), and 1 had diffuse large B-cell lymphoma-associated HLH. 4 patients showed unilateral or bilateral focal retinal hemorrhage and exudates. 1 male patient performed bilateral retinal pigment epithelial detachment. The literature search results showed that a total of 1 paper on ocular involvement in HLH patients was retrieved from the Chinese database and 11 papers were retrieved from the foreign database. HLH mainly involved the optic nerve, retina and choroid.Conclusions:The ocular involvement of HLH is easy to be missed or misdiagnosed because of its occult onset and complex and diverse clinical manifestations. Early examination and effective treatment may save vision and avoid missing the opportunity of systemic treatment.