School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy; and.
Retina. 2022 Sep 1;42(9):1762-1771. doi: 10.1097/IAE.0000000000003504.
To evaluate the retinal circulation in patients with active acute leukemia, to correlate the perfusion metrics with systemic laboratory values, and to assess the vascular perfusion after leukemia remission.
Longitudinal study of 22 eyes from 12 patients with acute leukemia; healthy eyes were recruited as control subjects. All patients underwent optical coherence tomography angiography at baseline. Optical coherence tomography angiography was repeated in case of morphologic leukemia remission.
Patients' age ranged from 37 to 74 years. All participants had a 20/20 vision. In all leukemic eyes, optical coherence tomography angiography detected vascular alterations in the macula and the peripapillary region. Vessel density values in the superficial capillary plexus were lower in patients with leukemia than control subjects (46.8 ± 3.6 vs. 49.2 ± 2%, P = 0.08), irrespective of the presence of leukemic retinopathy (7 eyes, 32%). Lower vessel density was associated with lower white blood cells ( P = 0.09) and lower platelets ( P = 0.001). Reappearance of small capillaries, increase in vessel density, reduction in vessel diameter, and increase in fractal dimension were seen after remission.
Subclinical, reversible reduction in vessel density and complexity on optical coherence tomography angiography occurs in patients with active acute leukemia and is presumably associated with bone marrow function failure. Further studies are warranted to explore its functional and prognostic significance.
评估活动期急性白血病患者的视网膜循环，将灌注指标与全身实验室值相关联，并评估白血病缓解后的血管灌注情况。
对 12 例急性白血病患者的 22 只眼进行了纵向研究；健康眼被招募为对照。所有患者均在基线时进行了光相干断层扫描血管造影。在形态学白血病缓解的情况下，重复光相干断层扫描血管造影。
患者年龄为 37 至 74 岁。所有参与者均有 20/20 的视力。在所有白血病眼中，光相干断层扫描血管造影均检测到黄斑区和视盘周围区域的血管改变。与对照组相比，白血病患者浅层毛细血管丛的血管密度值较低（46.8 ± 3.6 对 49.2 ± 2%，P = 0.08），无论是否存在白血病性视网膜病变（7 只眼，32%）。较低的血管密度与较低的白细胞（P = 0.09）和较低的血小板（P = 0.001）相关。缓解后可见小血管重现、血管密度增加、血管直径减小和分形维数增加。
活动期急性白血病患者的光相干断层扫描血管造影出现亚临床、可逆的血管密度和复杂性降低，推测与骨髓功能衰竭有关。需要进一步研究来探讨其功能和预后意义。
