Ophthalmic manifestations of leukemia in a tertiary hospital population of adult Nigerian Africans

ABSTRACT

To determine the prevalence and pattern of leukemic ophthalmopathy among adults at the University of Nigeria Teaching Hospital [UNTH], Enugu, south-eastern, Nigeria. This prospective, observational case series surveyed adult leukemia patients presenting at UNTH's departments of Hematology/Immunology and Ophthalmology from July 2003 to August 2008. The demographic profile, clinical data from for each individual in the cohort were statistically collated and analyzed. A P <0.05 was considered as statistically significant. There were 72 participants [45 males and 27 females], aged 32.7 +/- 9.8 years [range, 18 years to 72 years]. Leukemic ophthalmopathy was present in 77.8% of subjects. The leading ophthalmic manifestations of leukemia were retinal vascular abnormalities in 50.0% of subjects, conjunctival pallor in 27.8% of subjects, sub-conjunctival hemorrhage in 19.4% of subjects, and retinal hemorrhage in 16.7% of subjects. Ocular co-morbidity was present in 47.2% of subjects. Vision loss occurred in 37.5% of subjects, of which 32.1% was leukemia related, and the remaining due to ocular co-morbidity. Leukemic ophthalmopathy was more prevalent in chronic leukemia [P <0.05], frequently affected the ocular posterior segment [P < 0.05], and often resulted from secondary hematologic complications [P <0.05]. There was no gender difference in the prevalence of leukemia [P = 0.0822] or leukemic ophthalmopathy [P = 0.6624]. The prevalence of leukemic ophthalmopathy in Enugu is high. It is often associated with significant ocular co-morbidity and vision loss. These have implications for clinicians involved in leukemia management. Early diagnosis and regular ophthalmic examinations are recommended to optimize treatment outcomes: