ABSTRACT
Objetivo Publicar las manifestaciones oculares en paciente con leucemia. Métodos Estudio observacional analítico de corte transversal, en pacientes con manifestaciones oculares por leucemia. Resultados Se evaluaron 14 ojos de 8 pacientes (5 mujeres y 3 varones) con leucemia. La edad promedio al diagnóstico de leucemia fue de 43 años (31-76 años). Seis ojos correspondían a pacientes con leucemia mieloide aguda (LMA), 4 ojos a pacientes con leucemia linfoide aguda (LLA), 2 ojos a pacientes con leucemia mieloide crónica (LMC) y 2 ojos a pacientes con leucemia de células peludas (LCP). Los hallazgos oculares primarios fueron: invasión coroidea en 12 ojos (85,7%), infiltración retiniana en 4 ojos (28,6%) y desórdenes neuroftalmológicos en 4 ojos (28,6%). La agudeza visual promedio mejoró de 0,689 a 0,449 logMAR (p 0,012) luego del tratamiento con quimioterapia sistémica e intratecal. De los 8 pacientes, 4 murieron debido a complicaciones de su enfermedad. Conclusiones Este es el primer artículo de múltiples manifestaciones oculares secundaria a leucemia en una población colombiana. Es importante tener en cuenta que este tipo de manifestaciones hacen parte de los síndromes de enmascaramiento por lo tanto es primordial hacer un diagnóstico y manejo precoz ya que en ocasiones está en riesgo la vida del paciente (AU)
Objective To report the ocular manifestations in patients with leukaemia. Methods This is a retrospective, descriptive and observational study in patients with ocular manifestations of leukaemia. Results A total of 14 eyes were evaluated corresponding to 8 patients (5 women and 3 men) with ocular manifestations of leukaemia. The mean age at diagnosis was 43 years (31-76 years). Six eyes corresponded to patients with acute myeloid leukaemia (AML), four eyes to acute lymphoid leukaemia (ALL), two eyes to chronic myeloid leukaemia (CML), and the remaining two belonged to patients with hairy cell leukaemia (HCL). The primary ocular findings were choroidal invasion in 12 eyes (85.7%), retinal infiltration in 4 eyes (28.6%), and neuro-ophthalmic disorders in 4 eyes (28.6%). The mean visual acuity improved from 0.689 to 0.449 (logMAR) (P=.012) after the systemic and intrathecal chemotherapy. Of the eight patients, four died from systemic complications of the underlying disease. Conclusions This is the first report of multiple ocular manifestations secondary to leukaemia in a Colombian population. It is important to keep in mind that this disease is included within the masquerade syndromes and that the ophthalmological findings that, while subtle, can also be devastating and be signs of a life-threatening disease (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Leukemia/complications , Eye Diseases/etiology , Retrospective Studies , Tomography, Optical Coherence , Colombia , Cross-Sectional Studies , Visual AcuityABSTRACT
OBJECTIVE: To report the ocular manifestations in patients with leukaemia. METHODS: This is a retrospective, descriptive and observational study in patients with ocular manifestations of leukaemia. RESULTS: A total of 14 eyes were evaluated corresponding to 8 patients (5 women and 3 men) with ocular manifestations of leukaemia. The mean age at diagnosis was 43 years (31-76 years). Six eyes corresponded to patients with acute myeloid leukaemia (AML), four eyes to acute lymphoid leukaemia (ALL), two eyes to chronic myeloid leukaemia (CML), and the remaining two belonged to patients with hairy cell leukaemia (HCL). The primary ocular findings were choroidal invasion in 12 eyes (85.7%), retinal infiltration in 4 eyes (28.6%), and neuro-ophthalmic disorders in 4 eyes (28.6%). The mean visual acuity improved from 0.689 to 0.449 (logMAR) (P=.012) after the systemic and intrathecal chemotherapy. Of the eight patients, four died from systemic complications of the underlying disease. CONCLUSIONS: This is the first report of multiple ocular manifestations secondary to leukaemia in a Colombian population. It is important to keep in mind that this disease is included within the masquerade syndromes and that the ophthalmological findings that, while subtle, can also be devastating and be signs of a life-threatening disease.
ABSTRACT
The cases is presented of a 38 year-old male with a constitutional syndrome, fever, multiple swollen lymph nodes, and hepatosplenomegaly of 2 months onset. There was also mention of headache, bilateral blurred vision, and myiodesopsias. Best correct visual acuity was 20/50 and 20/200. The anterior segment was unremarkable. The fundus of both eyes showed raised and erased discs, accompanied by serous detachment, greater in the left eye. Complementary studies of both eyes showed a visual field with increased blind spot; fluorescein angiography indicated late disc hyperfluorescence. The electroretinogram showed compromise of cones and rods, and the visual evoked potential detected alteration in the perception and conduction of stimuli. The imaging studies were essentially normal. During his hospital admission he presented with paraparesis, renal failure, endocrinopathy, skin alterations, and osteoblastic lesions with negative biopsies. Monoclonal gammopathy was documented, and the diagnosis of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes) syndrome was made. The chemotherapy started with dexamethasone/melphalan, with a good response at 3 months.
Subject(s)
Eye Diseases/etiology , Nervous System Diseases/etiology , POEMS Syndrome/complications , Adult , Humans , Male , POEMS Syndrome/diagnosisABSTRACT
OBJECTIVE: To report the indocyanine green videoangiography (ICG-V) characteristics of optociliary veins (OV) in optic nerve sheath meningioma (ONSM). DESIGN: Case series. PARTICIPANTS: Four eyes (patients) with OV and ONSM were examined. INTERVENTION: Indocyanine green videoangiography and intravenous fluorescein angiography (IVFA) were prospectively performed. MAIN OUTCOME MEASURES: The course of OV in ONSM cases was observed with ICG-V and IVFA. RESULTS: On ICG-V, the course of OV was followed from their origin at small tributaries of the central retinal vein, their junction with choroidal veins, and finally to their drainage in the vortex venous system. The authors found an inverse relationship between the degree of optic disc edema and the development and ease of visualization of the optociliary veins and their draining course through the choroidal circulation. The mean time from the injection of indocyanine green to the visualization of OV's draining choroidal vessels was 35.4 seconds (range, 25.4-50 seconds). Intravenous fluorescein angiography allowed visualization of OV only at the margins of the optic disc in all cases. CONCLUSION: Indocyanine green videoangiography provides important and new information in cases with OV and ONSM that is not obtained with IVFA. Such information may provide important knowledge regarding the hemodynamics of the choroidal circulation in normal and pathologic states.
