Ophthalmic Manifestations of Acute Leukemia: A Review
Journal of Ophthalmic and Optometric Sciences,
Vol. 3 No. 1 (2019),
1 Dey 2019
,
Page 20-29
https://doi.org/10.22037/joos.v3i1.31774
Abstract
Acute leukemias are the most prevalent neoplastic disorder among children. In these patients the leukemic cells or blasts have replaced normal hematopoietic cells in bone marrow and have spread to different extramedullary sites. Increased survival among leukemic patients in recent decades has led to diagnosing some previously less recognized complications among these patients. One of these morbidities is ophthalmic involvement. The presence of ophthalmic involvement among leukemia patients is associated with poor prognosis. Ophthalmic involvement is more common in patients with AML and in adult patients. Leukemia may involve any ocular tissue such as conjunctiva, sclera, cornea, anterior chamber, iris, lens, vitreous, retina, choroid and optic nerve. In this review, the ocular manifestations of leukemia have been discussed.
Keywords:
- Leukemia; Eye Manifestations; Review
How to Cite
Hashemieh , M., & Yadgari, M. (2019). Ophthalmic Manifestations of Acute Leukemia: A Review. Journal of Ophthalmic and Optometric Sciences, 3(1), 20–29. https://doi.org/10.22037/joos.v3i1.31774
References
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11. Szalontay L, Shad AT. Pediatric Acute Myeloid Leukemia : How to Improve Outcome ? Curr Pediatr Rep. 2014;26-37.
12. Bhatia S. Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up. Expert Rev Hematol. 2011;4(4):437-54.
13. Koshy J, John MJ, Thomas S, Kaur G, Batra N, Xavier WJ. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India. Indian J Ophthalmol. 2015;63(8):659-64.
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30. Sbeity ZH, Baydoun L, Schmidt S, Loeffler KU. Visual field changes in methotrexate therapy. Case report and review of the literature. J Med Liban. 2006;54(3):164-7.
31. Lochhead J, Salmon JF, Bron AJ. Cytarabine-induced corneal toxicity. Eye (Lond). 2003;17(5):677-8.
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33. Higa GM, Gockerman JP, Hunt AL, Jones MR, Horne BJ. The use of prophylactic eye drops during high-dose cytosine arabinoside therapy. Cancer. 1991;68(8):1691-3.
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36. Hobson EV, Craven I, Blank SC. Posterior reversible encephalopathy syndrome: a truly treatable neurologic illness. Perit Dial Int. 2012;32(6):590-4.
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38. Ding X, Herzlich AA, Bishop R, Tuo J, Chan CC. Ocular toxicity of fludarabine: a purine analog. Expert Rev Ophthalmol. 2008;3(1):97-109.
39. Fu C, Gombos DS, Lee J, George GC, Hess K, Whyte A, et al. Ocular toxicities associated with targeted anticancer agents: an analysis of clinical data with management suggestions. Oncotarget. 2017;8(35):58709-27.
40. Davis ME. Ocular Toxicity of Tyrosine Kinase Inhibitors. Oncol Nurs Forum. 2016;43(2):235-43.
41. McClelland CM, Harocopos GJ, Custer PL. Periorbital edema secondary to imatinib mesylate. Clin Ophthalmol. 2010;4:427-31.
42. Orhan B, Malbora B, Akça Bayar S, Avcı Z, Alioğlu B, Özbek N. Ophthalmologic Findings in Children with Leukemia: A Single-Center Study. Turk J Ophthalmol. 2016;46(2):62-7.
43. Reddy SC, Jackson N. Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters. Acta Ophthalmol Scand. 2004;82(1):81-5.
44. Awuah A, Asiedu K, Adanusa M, Ntodie M, Acquah E, Kyei S. A case of leukemic retinopathy mimicking common ischemic retinopathies. Clin Case Rep. 2015;4(2):133-7.
45. Douglas RS, Goldstein SM, Nichols C. Acute myelogenous leukaemia presenting as a conjunctival lesion and red eye. Acta Ophthalmol Scand. 2002;80(6):671-2.
46. Murthy R, Vemuganti GK, Honavar SG, Naik M, Reddy V. Extramedullary leukemia in children presenting with proptosis. J Hematol Oncol. 2009;2:4.
47. Russo V, Scott IU, Querques G, Stella A, Barone A, Delle Noci N. Orbital and ocular manifestations of acute childhood leukemia: clinical and statistical analysis of 180 patients. Eur J Ophthalmol. 2008;18(4):619-23.
48. Kulbacki E, Schneider E, Wang E. 'Hypopyon' in the anterior chamber: unilateral ocular relapse of acute myeloid leukaemia in a 2-year-old girl. Br J Haematol. 2013;162(3):293.
49. Nassiri N, Eslani M, Panahi N, Mehravaran S, Ziaei A, Djalilian AR. Ocular graft versus host disease following allogeneic stem cell transplantation: a review of current knowledge and recommendations. J Ophthalmic Vis Res. 2013;8(4):351-8.
50. Massa JM, De Vloo N, Jamotton L. The ocular manifestations of blood diseases. Bull Soc Belge Ophtalmol. 1966;142(1):1-413. (Article in French)
51. Hegde SP, Ursekar AT, Chitale AA. Relapsing acute myeloid leukemia presenting as hypopyon uveitis. Indian J Ophthalmol. 2011;59(5):391-3.
52. Skarsgård LS, Andersson MK, Persson M, Larsen AC, Coupland SE, Stenman G, et al. Clinical and genomic features of adult and paediatric acute leukaemias with ophthalmic manifestations. BMJ Open Ophthalmol. 2019;4(1):e000362.
53. Reddy SC, Jackson N, Menon BS. Ocular involvement in leukemia--a study of 288 cases. Ophthalmologica. 2003;217(6):441-5.
54. Charif Chefchaouni M, Belmekki M, Hajji Z, Kaur G, Batra N, and Xavier WJ, et al. Ophthalmic manifestations of acute leukemia. J Fr Ophtalmol. 2002;25(1):62-6. (Article in French)
55. Liu TYA, Johnson TV, Barnett BP, Scott AW. Evolution of Leukemic Retinal Hemorrhages Documented by Spectral-Domain OCT and Color Fundus Photography. Ophthalmol Retina. 2018;2(5):494-501.
56. Sharma H, Majumder PD, Rao C, Biswas J. A case of Acute Myeloid Leukemia masquerading as unilateral exudative detachment. Am J Ophthalmol Case Rep. 2016;4:47-9.
57. Wingard JR. Viral infections in leukemia and bone marrow transplant patients. Leuk Lymphoma. 1993;11 Suppl 2:115-25.
58. Song A, Dubovy SR, Berrocal AM, Murray T. Endogenous fungal retinitis in a patient with acute lymphocytic leukemia manifesting as uveitis and optic nerve lesion. Arch Ophthalmol. 2002;120(12):1754-6.
59. Taylor CW, Taylor RE, Kinsey SE. Leukemic infiltration of the orbit: report of three cases and literature review. Pediatr Hematol Oncol. 2005;22(5):415-22.
60. Myers KA, Nikolic A, Romanchuk K, Weis E, Brundler MA, Lafay-Cousin L, et al. Optic neuropathy in the context of leukemia or lymphoma: diagnostic approach to a neuro-oncologic emergency. Neurooncol Pract. 2017;4(1):60-6.
61. Patel SA. Acute Myeloid Leukemia Relapse Presenting as Complete Monocular Vision Loss due to Optic Nerve Involvement. Case Rep Hematol. 2016;2016:3794284.
62. Finger PT, Pro MJ, Schneider S, Kurli M, Shapira I, Hu K. Visual recovery after radiation therapy for bilateral subfoveal acute myelogenous leukemia (AML). Am J Ophthalmol. 2004;138(4):659-62.
63. Schocket LS, Massaro-Giordano M, Volpe NJ, Galetta SL. Bilateral optic nerve infiltration in central nervous system leukemia. Am J Ophthalmol. 2003;135(1):94-6.
64. Bandyopadhyay S, Das D, Das G, Gayen S. Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission. Oman J Ophthalmol. 2010;3(3):153-4.
65. Fozza C, Dore F, Isoni MA, Longu F, Dessì L, Coppola L, et al. Strabismus and diplopia in a patient with acute myeloid leukemia. Am J Case Rep. 2014;15:288-90.
66. Madsen ML, Due H, Ejskjær N, Jensen P, Madsen J, Dybkær K. Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review. Cancer Chemother Pharmacol. 2019;84(3):471-85.
67. Ansari S, Rauniyar RK, Dhungel K, Sah PL, Ahmad K, Gupta MK, et al. Acute myeloid leukemia presenting as bilateral proptosis and right temporal swelling. Oman J Ophthalmol. 2014;7(1):35-7.
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2. Zhang L, Samad A, Pombo-de-Oliveira MS, et al. Global characteristics of childhood acute promyelocytic leukemia. Blood Rev. 2015;29(2):101-25.
3. Percival ME, Lai C, Estey E, Hourigan CS. Bone marrow evaluation for diagnosis and monitoring of acute myeloid leukemia. Blood Rev. 2017;31(4):185-92.
4. Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017;7(6):e577.
5. Meena JP, Ahad A, Gupta AK, Mallick S, Seth R. Bone relapse in T-lineage acute lymphoblastic leukemia in a child. Oxf Med Case Reports. 2018;2018(10):omx110.
6. Plasschaert SL, Kamps WA, Vellenga E, de Vries EG, de Bont ES. Prognosis in childhood and adult acute lymphoblastic leukaemia: a question of maturation?. Cancer Treat Rev. 2004;30(1):37-51.
7. Frost BM, Forestier E, Gustafsson G, Nygren P, Hellebostad M, Jonmundsson G, et al. Translocation t (1;19) is related to low cellular drug resistance in childhood acute lymphoblastic leukaemia. Leukemia. 2005;19(1):165-9.
8. Abramson N, Melton B. Leukocytosis: basics of clinical assessment. Am Fam Physician. 2000;62(9):2053-60.
9. Lagunas-Rangel FA, Chávez-Valencia V, Gómez-Guijosa MÁ, Cortes-Penagos C. Acute Myeloid Leukemia-Genetic Alterations and Their Clinical Prognosis. Int J Hematol Oncol Stem Cell Res. 2017;11(4):328-39.
10. Grove CS, Vassiliou GS. Acute myeloid leukaemia: a paradigm for the clonal evolution of cancer?. Dis Model Mech. 2014;7(8):941-51.
11. Szalontay L, Shad AT. Pediatric Acute Myeloid Leukemia : How to Improve Outcome ? Curr Pediatr Rep. 2014;26-37.
12. Bhatia S. Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up. Expert Rev Hematol. 2011;4(4):437-54.
13. Koshy J, John MJ, Thomas S, Kaur G, Batra N, Xavier WJ. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India. Indian J Ophthalmol. 2015;63(8):659-64.
14. Sharma T, Grewal J, Gupta S, Murray PI. Ophthalmic manifestations of acute leukaemias: the ophthalmologist's role. Eye (Lond). 2004;18(7):663-72.
15. Hafeez MU, Ali MH, Najib N, Ayub MH, Shafi K, Munir M, et al. Ophthalmic Manifestations of Acute Leukemia. Cureus. 2019;11(1):e3837.
16. Patel AV, Miller JB, Nath R, Shih HA, Yoon MK, Freitag SK, et al. Unilateral Eye Findings: A Rare Herald of Acute Leukemia. Ocul Oncol Pathol. 2016;2(3):166-70.
17. Bitirgen G, Belviranli S, Caliskan U, Tokgoz H, Ozkagnici A, Zengin N. Ophthalmic manifestations in recently diagnosed childhood leukemia. Eur J Ophthalmol. 2016;26(1):88-91.
18. Lenk L, Alsadeq A, Schewe DM. Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data. Cancer Metastasis Rev. 2020;39(1):173-87.
19. Dhasmana R, Prakash A, Gupta N, Verma SK. Ocular manifestations in leukemia and myeloproliferative disorders and their association with hematological parameters. Ann Afr Med. 2016;15(3):97-103.
20. Talcott KE, Garg RJ, Garg SJ. Ophthalmic manifestations of leukemia. Curr Opin Ophthalmol. 2016;27(6):545-51.
21. Kincaid MC, Green WR. Ocular and orbital involvement in leukemia. Surv Ophthalmol. 1983;27(4):211-32.
22. Gawai D, Jhavar S, Patil S. Orbital and ocular manifestations of acute and chronic leukemia. Int J Health Sci Res. 2016;6(9):61-4.
23. Omoti AE, Omoti CE. Ocular toxicity of systemic anticancer chemotherapy. Pharm Pract (Granada). 2006;4(2):55-9.
24. de Queiroz Mendonca C, Freire MV, Viana SS, Silva Tavares MKG, Almeida Silva WM, Cipolotti R. Ocular manifestations in acute lymphoblastic leukemia: A five-year cohort study of pediatric patients. Leuk Res. 2019;76:24-8.
25. Toker E, Yenice O, Oğüt MS. Isolated abducens nerve palsy induced by vincristine therapy. J AAPOS. 2004;8(1):69-71.
26. Albert DM, Wong VG, Henderson ES. Ocular complications of vincristine therapy. Arch Ophthalmol. 1967;78(6):709-13.
27. al-Tweigeri T, Nabholtz JM, Mackey JR. Ocular toxicity and cancer chemotherapy. A review. Cancer. 1996;78(7):1359-73.
28. von Stackelberg A, Hartmann R, Bührer C, Fengler R, Janka-Schaub G, Reiter A, et al. High-dose compared with intermediate-dose methotrexate in children with a first relapse of acute lymphoblastic leukemia. Blood. 2008;111(5):2573-80.
29. Garcia-Martin E, Pinilla I, Pueyo V, Gil L, Martinez-Morales J, Fernandez J. Bilateral Internuclear Ophthalmoplegia in a Patient with Devic's Neuromyelitis Optica. Case Rep Neurol. 2010;2(3):139-44.
30. Sbeity ZH, Baydoun L, Schmidt S, Loeffler KU. Visual field changes in methotrexate therapy. Case report and review of the literature. J Med Liban. 2006;54(3):164-7.
31. Lochhead J, Salmon JF, Bron AJ. Cytarabine-induced corneal toxicity. Eye (Lond). 2003;17(5):677-8.
32. Ritch PS, Hansen RM, Heuer DK. Ocular toxicity from high-dose cytosine arabinoside. Cancer. 1983;51(3):430-2.
33. Higa GM, Gockerman JP, Hunt AL, Jones MR, Horne BJ. The use of prophylactic eye drops during high-dose cytosine arabinoside therapy. Cancer. 1991;68(8):1691-3.
34. Gatza E, Choi SW. Approaches for the prevention of graft-versus-host disease following hematopoietic cell transplantation. Int J Hematol Oncol. 2015;4(3):113-26.
35. Saeed B, Abou-Zor N, Amer Z, Kanani I, Hilal M. Cyclosporin-A induced posterior reversible encephalopathy syndrome. Saudi J Kidney Dis Transpl. 2008;19(3):439-42.
36. Hobson EV, Craven I, Blank SC. Posterior reversible encephalopathy syndrome: a truly treatable neurologic illness. Perit Dial Int. 2012;32(6):590-4.
37. Kaida T, Ogawa T, Amemiya T. Cataract induced by short-term administration of large doses of busulfan: a case report. Ophthalmologica. 1999;213(6):397-9.
38. Ding X, Herzlich AA, Bishop R, Tuo J, Chan CC. Ocular toxicity of fludarabine: a purine analog. Expert Rev Ophthalmol. 2008;3(1):97-109.
39. Fu C, Gombos DS, Lee J, George GC, Hess K, Whyte A, et al. Ocular toxicities associated with targeted anticancer agents: an analysis of clinical data with management suggestions. Oncotarget. 2017;8(35):58709-27.
40. Davis ME. Ocular Toxicity of Tyrosine Kinase Inhibitors. Oncol Nurs Forum. 2016;43(2):235-43.
41. McClelland CM, Harocopos GJ, Custer PL. Periorbital edema secondary to imatinib mesylate. Clin Ophthalmol. 2010;4:427-31.
42. Orhan B, Malbora B, Akça Bayar S, Avcı Z, Alioğlu B, Özbek N. Ophthalmologic Findings in Children with Leukemia: A Single-Center Study. Turk J Ophthalmol. 2016;46(2):62-7.
43. Reddy SC, Jackson N. Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters. Acta Ophthalmol Scand. 2004;82(1):81-5.
44. Awuah A, Asiedu K, Adanusa M, Ntodie M, Acquah E, Kyei S. A case of leukemic retinopathy mimicking common ischemic retinopathies. Clin Case Rep. 2015;4(2):133-7.
45. Douglas RS, Goldstein SM, Nichols C. Acute myelogenous leukaemia presenting as a conjunctival lesion and red eye. Acta Ophthalmol Scand. 2002;80(6):671-2.
46. Murthy R, Vemuganti GK, Honavar SG, Naik M, Reddy V. Extramedullary leukemia in children presenting with proptosis. J Hematol Oncol. 2009;2:4.
47. Russo V, Scott IU, Querques G, Stella A, Barone A, Delle Noci N. Orbital and ocular manifestations of acute childhood leukemia: clinical and statistical analysis of 180 patients. Eur J Ophthalmol. 2008;18(4):619-23.
48. Kulbacki E, Schneider E, Wang E. 'Hypopyon' in the anterior chamber: unilateral ocular relapse of acute myeloid leukaemia in a 2-year-old girl. Br J Haematol. 2013;162(3):293.
49. Nassiri N, Eslani M, Panahi N, Mehravaran S, Ziaei A, Djalilian AR. Ocular graft versus host disease following allogeneic stem cell transplantation: a review of current knowledge and recommendations. J Ophthalmic Vis Res. 2013;8(4):351-8.
50. Massa JM, De Vloo N, Jamotton L. The ocular manifestations of blood diseases. Bull Soc Belge Ophtalmol. 1966;142(1):1-413. (Article in French)
51. Hegde SP, Ursekar AT, Chitale AA. Relapsing acute myeloid leukemia presenting as hypopyon uveitis. Indian J Ophthalmol. 2011;59(5):391-3.
52. Skarsgård LS, Andersson MK, Persson M, Larsen AC, Coupland SE, Stenman G, et al. Clinical and genomic features of adult and paediatric acute leukaemias with ophthalmic manifestations. BMJ Open Ophthalmol. 2019;4(1):e000362.
53. Reddy SC, Jackson N, Menon BS. Ocular involvement in leukemia--a study of 288 cases. Ophthalmologica. 2003;217(6):441-5.
54. Charif Chefchaouni M, Belmekki M, Hajji Z, Kaur G, Batra N, and Xavier WJ, et al. Ophthalmic manifestations of acute leukemia. J Fr Ophtalmol. 2002;25(1):62-6. (Article in French)
55. Liu TYA, Johnson TV, Barnett BP, Scott AW. Evolution of Leukemic Retinal Hemorrhages Documented by Spectral-Domain OCT and Color Fundus Photography. Ophthalmol Retina. 2018;2(5):494-501.
56. Sharma H, Majumder PD, Rao C, Biswas J. A case of Acute Myeloid Leukemia masquerading as unilateral exudative detachment. Am J Ophthalmol Case Rep. 2016;4:47-9.
57. Wingard JR. Viral infections in leukemia and bone marrow transplant patients. Leuk Lymphoma. 1993;11 Suppl 2:115-25.
58. Song A, Dubovy SR, Berrocal AM, Murray T. Endogenous fungal retinitis in a patient with acute lymphocytic leukemia manifesting as uveitis and optic nerve lesion. Arch Ophthalmol. 2002;120(12):1754-6.
59. Taylor CW, Taylor RE, Kinsey SE. Leukemic infiltration of the orbit: report of three cases and literature review. Pediatr Hematol Oncol. 2005;22(5):415-22.
60. Myers KA, Nikolic A, Romanchuk K, Weis E, Brundler MA, Lafay-Cousin L, et al. Optic neuropathy in the context of leukemia or lymphoma: diagnostic approach to a neuro-oncologic emergency. Neurooncol Pract. 2017;4(1):60-6.
61. Patel SA. Acute Myeloid Leukemia Relapse Presenting as Complete Monocular Vision Loss due to Optic Nerve Involvement. Case Rep Hematol. 2016;2016:3794284.
62. Finger PT, Pro MJ, Schneider S, Kurli M, Shapira I, Hu K. Visual recovery after radiation therapy for bilateral subfoveal acute myelogenous leukemia (AML). Am J Ophthalmol. 2004;138(4):659-62.
63. Schocket LS, Massaro-Giordano M, Volpe NJ, Galetta SL. Bilateral optic nerve infiltration in central nervous system leukemia. Am J Ophthalmol. 2003;135(1):94-6.
64. Bandyopadhyay S, Das D, Das G, Gayen S. Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission. Oman J Ophthalmol. 2010;3(3):153-4.
65. Fozza C, Dore F, Isoni MA, Longu F, Dessì L, Coppola L, et al. Strabismus and diplopia in a patient with acute myeloid leukemia. Am J Case Rep. 2014;15:288-90.
66. Madsen ML, Due H, Ejskjær N, Jensen P, Madsen J, Dybkær K. Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review. Cancer Chemother Pharmacol. 2019;84(3):471-85.
67. Ansari S, Rauniyar RK, Dhungel K, Sah PL, Ahmad K, Gupta MK, et al. Acute myeloid leukemia presenting as bilateral proptosis and right temporal swelling. Oman J Ophthalmol. 2014;7(1):35-7.
68. Purohit BS, Vargas MI, Ailianou A, Merlini L, Poletti PA, Platon A, et al. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging. Insights Imaging. 2016;7(1):43-68.
69. Chaudhry IA, Alaraj AM, Alkatan HM. Unilateral eyelid swelling, proptosis and diplopia as initial manifestation of acute myeloid leukemia. Saudi J Ophthalmol. 2012;26(2):241-4.
70. Bidar M, Wilson MW, Laquis SJ, Wilson TD, Fleming JC, Wesley RE, et al. Clinical and imaging characteristics of orbital leukemic tumors. Ophthalmic Plast Reconstr Surg. 2007;23(2):87-93.
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