Cicek Meryem Feyza, Oba Turker, Perk Fatma Feyza Nur Keskin, Ayer Mesut, Onder Feyza
Department of Ophthalmology, Dünyagöz Hospital, Üsküdar, 34662, İstanbul, Turkey.
Department of Ophthalmology, Dünyagöz Hospital, Tekirdağ, Turkey.
Jpn J Ophthalmol. 2025 May 26. doi: 10.1007/s10384-025-01216-0.
To quantitatively assess the microvascular alterations and structural parameters in the optic disc, retina, and choriocapillaris of chronic myeloid leukemia (CML) patients devoid of leukemic retinopathy, while also examining the correlation between these parameters and serum laboratory results.
Prospective, cross-sectional, observational clinical study METHODS: This study included 30 eyes from 15 patients diagnosed with CML and 30 eyes from age 15- and gender-matched healthy individuals (control group). All participants underwent comprehensive ophthalmologic assessments, including optical coherence tomography angiography (OCTA). Statistical analyses, including Student's t-test and the Mann-Whitney U test, were conducted to compare structural and vascular parameters between CML patients and controls. Spearman's correlation was used to evaluate the relationship between OCTA measurements and serum parameters.
The analysis of macular vessel density revealed significant reductions in all assessed parameters in the patient group compared to the control group. These parameters include whole image superficial vessel density (wisVD, p=0.005), parafoveal superficial vessel density (pfsVD, p=0.002), perifoveal superficial vessel density (pefsVD, p=0.007), whole image deep vessel density (widVD, p=0.005), parafoveal deep vessel density (pfdVD, p=0.004), and perifoveal deep vessel density (pefdVD, p=0.005). Higher white blood cell levels were associated with lower optic nerve head whole image VD, wisVD, pfsVD, pefsVD, widVD, and pefdVD. Higher platelet levels were correlated with lower widVD. Additionally, hemoglobin showed a positive correlation with choriocapillaris vessel flow density, while it exhibited a negative correlation with superior and inferior macular ganglion cell complex thickness.
Subclinical retinal perfusion loss was observed in CML patients, and this perfusion loss was associated with hematological parameters. The marked reduction in macular perfusion could be valuable for understanding the pathogenesis of the disease and predicting potential retinal complications such as hypoxia and ischemia in more advanced stages. Further studies are needed to investigate the functional and prognostic significance of the changes we observed.
定量评估无白血病视网膜病变的慢性髓性白血病（CML）患者视盘、视网膜和脉络膜毛细血管的微血管改变及结构参数，同时研究这些参数与血清实验室检查结果之间的相关性。
前瞻性、横断面、观察性临床研究
本研究纳入了15例诊断为CML患者的30只眼以及年龄和性别匹配的健康个体（对照组）的30只眼。所有参与者均接受了全面的眼科评估，包括光学相干断层扫描血管造影（OCTA）。进行了包括Student's t检验和Mann-Whitney U检验在内的统计分析，以比较CML患者和对照组之间的结构和血管参数。采用Spearman相关性分析评估OCTA测量值与血清参数之间的关系。
黄斑血管密度分析显示，与对照组相比，患者组所有评估参数均显著降低。这些参数包括全图像表层血管密度（wisVD，p = 0.005）、黄斑旁表层血管密度（pfsVD，p = 0.002）、黄斑周围表层血管密度（pefsVD，p = 0.007）、全图像深层血管密度（widVD，p = 0.005）、黄斑旁深层血管密度（pfdVD，p = 0.004）和黄斑周围深层血管密度（pefdVD，p = 0.005）。白细胞水平越高，视神经乳头全图像VD、wisVD、pfsVD、pefsVD、widVD和pefdVD越低。血小板水平越高，与widVD越低相关。此外，血红蛋白与脉络膜毛细血管血流密度呈正相关，而与黄斑上下神经节细胞复合体厚度呈负相关。
在CML患者中观察到亚临床视网膜灌注损失，且这种灌注损失与血液学参数相关。黄斑灌注的显著降低对于理解疾病的发病机制以及预测更晚期潜在的视网膜并发症如缺氧和缺血可能具有重要价值。需要进一步研究来探讨我们观察到的这些变化的功能和预后意义。
