OPHTHALMOLOGICAL MANIFESTATIONS OF CHRONIC MYELOID LEUKEMIA (ONSET)
Abstract
The course of chronic myeloid leukemia (CML) can be accompanied by various vascular complications and changes in tissues and organs of the entire body, including the organ of vision.
Оbjective. A clinical case of a patient's initial visit to an ophthalmological clinic with complaints of decreased visual acuity in the onset of chronic myeloid leukemia is described.
Clinical case. A 28-year-old patient with complaints of the appearance of «fog», decreased visual acuity in his left eye came to the emergency department. Ophthalmoscopy revealed moderately dilated and convoluted retinal veins, single variegated retinal hemorrhages along the course of vascular arcades, including the macular area on the left eye. According to the clinical examination, the results of a clinical blood test, morphological and cytogenetic examination of a bone marrow trepanobioptate with the detection of the Philadelphia chromosome in 96% of cells, the diagnosis of CML, chronic phase was verified.
Conclusion. Clinical onset of CML is possible with ocular manifestations, which indicates the need for hematological alertness during ophthalmological examination. The coordinated work of hematologists and ophthalmologists contributes not only to the timely diagnosis and treatment of patients with CML, but also to the assessment of the dynamics and results of systemic and targeted therapy.
About the Authors
L. B. Egoryan
ФГБОУ ДПО «Российская академия непрерывного профессионального образования» Минздрава России; ГБУЗ «Городская клиническая больница имени С.П. Боткина»
Russian Federation
Russian Federation
L. K. Moshetova
ФГБОУ ДПО «Российская академия непрерывного профессионального образования» Минздрава России
Russian Federation
Russian Federation
O. J. Vinogradova
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава России; ГБУЗ «Городская клиническая больница имени С.П. Боткина»; ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Минздрава России
Russian Federation
Russian Federation
D. I. Shikhbabaeva
ГБУЗ «Городская клиническая больница имени С.П. Боткина»
Russian Federation
Russian Federation
K. I. Turkina
ФГБОУ ДПО «Российская академия непрерывного профессионального образования» Минздрава России; ГБУЗ «Городская клиническая больница имени С.П. Боткина»
Russian Federation
Russian Federation
References
1. Howlader N, Noone AM, Krapcho M, [et al.] SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). [Electronic resource] In: Bethesda, MD: National Cancer Institute; 1975-2017. URL: https://seer.cancer.gov/csr/1975_2009_pops09. (accessed July 8, 2020). (in Engl)
2. Rollison DE, Howlader N, Smith MT, [et al.] Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs. Blood 2008;112(1):45–52. (in Engl)
3. Rosenthal AR. Ocular manifestations of leukemia, a review. Ophthalmology. 1983;90 (8):899–905(in Engl)
4. Young J.M., Jusufbegovic D. Extramedullary retinal involvement in chronic myeloid leukemia. Ophthalmol Retina 2019; 3(2): 132. (in Engl)
5. Cuttler N., Heidemann D., Cendrowski C., Armin A.-R., Folberg R. Extramedullary Hematopoiesis of the Conjunctiva Presenting as Active Systemic Disease in a Patient with Myelofibrosis. Cornea 2014, 33 (12),1352–1354. (in Engl) doi:10.1097/ICO.0000000000000274
6. Michiels J.J., van Genderen P.J., Jansen P.H., Koudstaal P.J. Atypical Transient Ischemic Attacks in Thrombocythemia of Various Myeloproliferative Disorders. Leuk. Lymphoma 1996, 22, 65–70. (in Engl) doi:10.3109/10428199609074362.
7. Vicini G, Nicolosi C, Malandrino D, Tozzetti C. [et al.]. Leukostasis retinopathy with leukemic infiltrates as onset manifestation of chronic myeloid leukemia: a case report. Eur J Ophthalmol. 2021;31(5):NP116–NP121. (in Engl) doi: https://doi.org/10.1177/1120672120930679
8. Pekel G, Doğu MH, Keskin A. [et al.] Subfoveal Choroidal Thickness Is Associated with Blood Hematocrit Level. Ophthalmologica. 2015;234(1):55–59. (in Engl) doi: https://doi.org/10.1159/000433449.
9. Sharma PV, Ilyas O, Jobanputra Y. [et al.] Is it always cancer? A curious case of benign intracranial hypertension in chronic myeloid leukemia. Intractable Rare Dis Res. 2018;7(3):182–184. (in Engl) doi: https://doi.org/10.5582/irdr.2018.01045
10. Jacob Koshy, M Joseph John, Satish Thomas. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India Indian J Ophthalmol. 2015 Aug;63(8):659-64. (in Engl) doi: 10.4103/0301-4738.169789.
11. Savya Soman, Nirupama Kasturi. Ocular Manifestations in Leukemias and Their Correlation with Hematologic Parameters at a Tertiary Care Setting in South India Ophthalmol Retina. 2018 Jan;2(1):17-23. (in Engl) doi: 10.1016/j.oret.2017.05.009.
12. Chen B, Yan X, Zhang X. [et al.] Leukostasis retinopathy: an uncommon visual threatening complication of chronic myeloid leukemia with severe hyperleukocytosis—A case report and review of the literature. Indian J Ophthalmol 2018; 66(12): 1871–1874. (in Engl)
13. Huang PK, Sanjay S. Visual disturbance as the first symptom of chronic myeloid leukemia. Middle East Afr J Ophthalmol. 2011;18(4):336–338. (in Engl)
14. Solin Saleh, Kaisra Esmail, Danah Albreiki. Subjective intermittent colour vision loss as the initial presentation of chronic myeloid leukemia American Journal of Ophthalmology Case Reports Volume 19, September 2020, 100817 (in Engl) doi: 10.1016/j.ajoc.2020.100817.
15. Yunusova E.M., Mukhamadeev T.R., Bakirov B.A. Assessment of ocular manifestation frequency and quality of life in chronic myeloproliferative disorders. Bulletin of RSMU 2022;(3):86-90 (In Russ). doi:10.24075/vrgmu.2022.027
16. Yunusova EM, Bakirov BA, Mukhamadeev TR. Ophthalmic manifestations of chronic myeloproliferative diseases. Bashkortostan Medical Journal. 2021;16(5):52–56. (In Russ.)
17. Mohamed M, Oakley C, McEwen F, [et al.] Leucapheresis for management of retinopathy in chronic myeloid leukaemia. BMJ Case Rep 2015; 2015: bcr2015212889. (in Engl)
18. Vicini G, Nicolosi C, Malandrino D, Tozzetti, et al. (2020). Leukostasis retinopathy with leukemic infiltrates as onset manifestation of chronic myeloid leukemia: a case report. Eur J Ophthalmol. 2021;31(5):NP116–NP121. (in Engl) doi: https://doi.org/10.1177/1120672120930679
19. Dhasmana R, Prakash A, Gupta N, Verma SK. Ocular manifestations in leukemia and myeloproliferative disorders and their association with hematologic parameters. Ann Afr Med. 2016;15(3):97–103. (in Engl)
20. Mohamed M, Oakley C, McEwen F. [et al.] Leucapheresis for management of retinopathy in chronic myeloid leukaemia. BMJ Case Rep 2015; 2015: bcr2015212889. (in Engl).
Review
For citations:
Egoryan L.B., Moshetova L.K., Vinogradova O.J., Shikhbabaeva D.I., Turkina K.I. OPHTHALMOLOGICAL MANIFESTATIONS OF CHRONIC MYELOID LEUKEMIA (ONSET). Bashkortostan Medical Journal. 2023;18(6):75-80. (In Russ.)
Views:
30
Email this article 
