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浆液性视网膜脱离作为白血病性脉络膜病变的一个征象:一项系统性综述。

Serous retinal detachment as a sign of leukemic choroidopathy: A systematic review.

机构信息

Retina and Vitreous Department at Asociación Para Evitar la Ceguera (APEC), CDMX, México, I.A.P.; Latin American Network for Research in Eye Diseases-LANRED.

Retina and Vitreous Department at Asociación Para Evitar la Ceguera (APEC), CDMX, México, I.A.P.; Latin American Network for Research in Eye Diseases-LANRED.

出版信息

Surv Ophthalmol. 2022 Jan-Feb;67(1):149-167. doi: 10.1016/j.survophthal.2021.04.007. Epub 2021 Apr 29.

DOI:10.1016/j.survophthal.2021.04.007
PMID:33933437
Abstract

Leukemia is a rare disease associated with a high mortality rate. The presence of unilateral or bilateral serous retinal detachment (SRD) as a sign of choroidal infiltration can be one of the manifestations of acute leukemia, both as a primary sign or in a relapse. We consolidated the literature on SRD as a sign of leukemic choroidopathy regarding its epidemiology, clinical manifestations, and main imaging diagnostic tools. Well-documented cases regarding acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), relapsed ALL and relapsed AML published until September, 2020, in peer reviewed journals were included. The literature shows an interesting range of choroidal infiltration cases assessed by modern imaging techniques, such as optical coherence tomography (OCT) with and without enhanced depth imaging (EDI) and fluorescein angiography (FA). These tools allow choroidal assessment and better understanding and characterization of this rare condition. Complete ophthalmological workup should be performed in these patients using both FA and EDI-OCT to assess the choroidal anatomy and integrity. An increase in choroidal thickness measured with EDI-OCT can reveal active disease and potentially diagnose a leukemic relapse promptly.

摘要

白血病是一种罕见的疾病,死亡率较高。单侧或双侧浆液性视网膜脱离(SRD)作为脉络膜浸润的标志之一,可能是急性白血病的表现之一,无论是作为首发症状还是复发时出现。我们就 SRD 作为白血病性脉络膜病变的标志,对其流行病学、临床表现和主要影像学诊断工具进行了文献综述。纳入了截至 2020 年 9 月在同行评议期刊上发表的关于急性淋巴细胞白血病(ALL)、急性髓细胞性白血病(AML)、复发 ALL 和复发 AML 的有充分记录的病例。文献显示,通过现代影像学技术(如带有和不带有增强深度成像(EDI)的光学相干断层扫描(OCT)和荧光素血管造影(FA))评估了一系列有趣的脉络膜浸润病例。这些工具允许对脉络膜进行评估,并更好地理解和描述这种罕见情况。应使用 FA 和 EDI-OCT 对这些患者进行全面的眼科检查,以评估脉络膜的解剖结构和完整性。EDI-OCT 测量的脉络膜厚度增加可能提示疾病活动,并且可能能够及时诊断出白血病复发。

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引用本文的文献

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Assessment of retinal, choroidal and peripapillary microvascular changes in patients with chronic myeloid leukemia.慢性髓性白血病患者视网膜、脉络膜及视乳头周围微血管变化的评估
Jpn J Ophthalmol. 2025 May 26. doi: 10.1007/s10384-025-01216-0.
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Bilateral optic nerve infiltration and leukemic retinopathy as initial signs of leukemia relapse with central nervous system involvement in an adult: a case report.成人双侧视神经浸润和白血病性视网膜病变作为伴有中枢神经系统受累的白血病复发的首发表现:1 例报告。
BMC Ophthalmol. 2024 May 28;24(1):225. doi: 10.1186/s12886-024-03486-7.
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Bilateral serous retinal detachment: An initial presentation of mixed phenotype acute leukemia in an adult.
双侧浆液性视网膜脱离:一名成人混合表型急性白血病的首发表现。
Oman J Ophthalmol. 2022 Nov 2;15(3):356-359. doi: 10.4103/ojo.ojo_93_22. eCollection 2022 Sep-Dec.