[Retinal abnormalities in adult acute myeloid leukemia: semeiological features and prognostic correlations. Analysis of 178 cases].
BACKGROUND
Adult patients with acute myeloid leukemia (AML) frequently present retinal abnormalities. We tried to find a relationship between fundus lesions and treatment responsiveness, prognosis, and several hematologic parameters.


METHODS
We examined 178 adult patients with newly diagnosed AML. All patients were assigned to two groups regarding retinal parameters (1 or 2) and age (A or B). Group 1 included cases with retinal dysfunction classified as retinal abnormalities with impaired visual acuity; group 2 included cases with no or only minor retinal changes. Subgroup A included patients younger than 60 years (n=97), subgroup B patients older than 60 years (n=81).


RESULTS
In this study, higher age and a lower Hb value were associated with retinal findings (group 1). Among the younger patients (subgroup A), 78% of those with complete remission had no retinal findings (group 2) compared to 18% of the nonresponders. In the elderly population (subgroup B), this ratio was 58% versus 19%. In the younger patients (subgroup A), the mean overall survival was 50 months if they had no retinal abnormalities (group 2) and 7 months in the case of retinal changes (group 1). In the older population (subgroup B), the ratio was 15 months versus 3 months, respectively.


CONCLUSIONS
Retinal abnormalities in AML are generally associated with higher age, although they correlate with a shorter survival in both age groups. This association is stronger in younger patients.
Querques
G
G
Service d'Ophtalmologie, Policlinico Riuniti di Foggia, Université de Foggia, Foggia, Italie. giuseppe.querques@hotmail.it
Russo
V
V
Martinez
A
A
Sarra
G M
GM
Iaculli
C
C
Delle Noci
N
N
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011379:Prognosis; D012164:Retinal Diseases / Q000453:epidemiology*; D016019:Survival Analysis; D016896:Treatment Outcome