骨髓增生异常综合征作为白血病前期疾病的眼部并发症。

Ocular complications in myelodysplastic syndromes as preleukemic disorders.

作者信息

Kezuka Takeshi, Usui Norio, Suzuki Etsuko, Wakasugi Kazunori, Usui Masahiko

机构信息

Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.

出版信息

Jpn J Ophthalmol. 2005 Sep-Oct;49(5):377-83. doi: 10.1007/s10384-005-0228-6.

DOI:10.1007/s10384-005-0228-6

PMID:16187037

Abstract

PURPOSE

To identify ocular complications in patients with myelodysplastic syndromes (MDS), who have a propensity to progress to acute myeloid leukemia (AML).

METHODS

Forty-one patients with MDS were the subjects in this retrospective study, and 21 patients with AML were selected as controls. Reviewing their clinical records, we verified that corneal ulcer, iridocyclitis, vitreous hemorrhage, retinal hemorrhage, and optic neuritis had been evaluated using slit-lamp assessment and opthalmoscopy in all the patients. In this study, the MDS patients were classified into those with refractory anemia (RA) and those with refractory anemia with excess blasts (RAEB).

RESULTS

Ocular complications were found in 19 (46.3%) of the 41 patients with MDS, comprising corneal ulcer (two cases), iridocyclitis (five), vitreous hemorrhage (one), retinal hemorrhage (ten), cotton wool spots (one), and optic neuritis (two). (Some patients had more than one ocular complication.) Ocular complications were identified in 12 of the 21 (57.1%) patients with AML. There was no significant difference in frequency of ocular complications between MDS and AML (P = 0.4892). In MDS, retinal hemorrhage was associated with significantly reduced platelet counts (P = 0.0063). The frequency of ocular complications was significantly higher in MDS-RAEB than in MDS-RA (P = 0.0478). Retinal hemorrhage was significantly more frequent in patients with MDS-RAEB than in patients with MDS-RA (P = 0.0433).

CONCLUSION

Ocular complications in MDS patients should be carefully examined as prognostic factors for progression to acute leukemia.

摘要

目的

确定骨髓增生异常综合征（MDS）患者的眼部并发症，这类患者有发展为急性髓系白血病（AML）的倾向。

方法

41例MDS患者为这项回顾性研究的对象，选取21例AML患者作为对照。通过查阅他们的临床记录，我们证实所有患者均已使用裂隙灯检查和检眼镜检查对角膜溃疡、虹膜睫状体炎、玻璃体出血、视网膜出血和视神经炎进行了评估。在本研究中，MDS患者被分为难治性贫血（RA）患者和伴有过多原始细胞的难治性贫血（RAEB）患者。

结果

41例MDS患者中有19例（46.3%）出现眼部并发症，包括角膜溃疡（2例）、虹膜睫状体炎（5例）、玻璃体出血（1例）、视网膜出血（10例）、棉絮斑（1例）和视神经炎（2例）。（有些患者有不止一种眼部并发症。）21例AML患者中有12例（57.1%）出现眼部并发症。MDS和AML患者眼部并发症的发生率无显著差异（P = 0.4892）。在MDS中，视网膜出血与血小板计数显著降低相关（P = 0.0063）。MDS-RAEB患者的眼部并发症发生率显著高于MDS-RA患者（P = 0.0478）。MDS-RAEB患者的视网膜出血明显比MDS-RA患者更常见（P = 0.0433）。