Ocular complications in myelodysplastic syndromes as preleukemic disorders.

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.