Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan.
BMC Ophthalmol. 2022 Apr 7;22(1):160. doi: 10.1186/s12886-022-02380-4.
Chronic myeloid leukemia (CML) is known to cause leukemic retinopathy due to leukemia cell invasion into the choroid; however, details of the circulatory dynamics and morphological changes in the choroid are unknown. The aim of this study was to present a case of leukemic retinopathy and examine choroidal circulatory and structural analyses using laser speckle flowgraphy (LSFG) and optical coherence tomography with a binarization method, respectively.
A 15-year-old male diagnosed with CML complained of blurred vision in his right eye. He was ophthalmologically diagnosed with leukemic retinopathy due to retinal hemorrhage in both eyes. Tyrosine kinase inhibitors achieved complete cytogenetic remission and resolution of retinal hemorrhages at 6 months after treatment. After the treatment, the best-corrected visual acuity had recovered from 0.1 to 1.2 oculus dexter (OD) and remained at 1.5 oculus sinister (OS). The rate of change in macular blood flow assessed by the mean blur rate on LSFG was 18.3% increase OD and 25.2% decrease OS 19 months after treatment. The central choroidal thickness showed 0.4 and 3.1% reductions OD and OS, respectively. The binarization technique demonstrated that the rate of luminal areas in choroidal areas exhibited 3.2% increase OD but 4.8% decrease OS.
Choroidal blood flow improved OD after treatment for CML, while it deteriorated OS, together with choroidal thinning due to reduction of luminal areas. The degrees of leukemia cell invasion into the choroidal tissue and tissue destruction might be different between the eyes in this case.
慢性髓细胞白血病（CML）已知可因白血病细胞侵犯脉络膜而导致白血病性视网膜病变；然而，脉络膜的循环动力学和形态变化的细节尚不清楚。本研究旨在介绍一例白血病性视网膜病变，并分别使用激光散斑血流图（LSFG）和光学相干断层扫描结合二值化方法检查脉络膜循环和结构分析。
一名 15 岁男性，诊断为 CML，主诉右眼视力模糊。他因双眼视网膜出血被眼科诊断为白血病性视网膜病变。酪氨酸激酶抑制剂在治疗后 6 个月达到完全细胞遗传学缓解和视网膜出血消退。治疗后，右眼最佳矫正视力从 0.1 恢复到 1.2，左眼仍为 1.5。LSFG 上平均模糊率评估的黄斑血流变化率在治疗后 19 个月时右眼增加 18.3%，左眼减少 25.2%。中央脉络膜厚度分别减少 0.4%和 3.1%。二值化技术显示脉络膜区域管腔面积的比率右眼增加 3.2%，但左眼减少 4.8%。
CML 治疗后右眼脉络膜血流改善，而左眼则恶化，同时由于管腔面积减少导致脉络膜变薄。在这种情况下，白血病细胞侵犯脉络膜组织和组织破坏的程度可能在两眼之间不同。
