Ocular manifestations of idiopathic aplastic anemia: retrospective study and literature review.
Aplastic anemia (AA) is a rare disease with few reports on its ophthalmic manifestations. The ocular findings are described in a retrospective consecutive series of 719 AA Korean patients followed at the Hematology Clinic of The Catholic University of Korea. Out of a total of 719 patients, 269 patients had eye examinations, 156 patients had retinal evaluation, and 37 (23.7%) had retinal findings. These 37 patients had unilateral retinal hemorrhage in seven and bilateral retinal hemorrhage in 30 with mean hemoglobin of 6.6 g/dL (range 2.7-12.6 g/dL) and platelet counts of 18.8×10(9)/L (range 4-157×10(9)/L); central retinal vein occlusion-like picture occurred in nine patients and these had similar rheology to the rest of the subjects; optic disc edema, cotton-wool spots, macular edema, and dry eyes occurred in two, three, five, and three patients, respectively. In this Korean series of 141 subjects with AA, systemic bleeding occurred in 24.8% of subjects, retinal hemorrhage in 37% of subjects, and any bleeding site (eye or elsewhere) occurred in 47.5% of subjects with AA. A literature review (1958-2010) of 200 AA cases revealed retinal hemorrhages in 56%, subhyaloid or vitreous hemorrhage in 9%, peripheral retinal vasculopathy in 5.5%, and cotton-wool spots, Sjögren's syndrome, or optic disc edema in 4% each. The prevalence of retinopathy among series of AA patients varied from 20% to 28.3%, which is consistent with the Korean series of 24.8%. Management of AA patients needs to involve multiple specialties, including hematologists, ophthalmologists, and infectious disease specialists.
Department of Ophthalmology, American University of Beirut, Rafic Hariri University Hospital, Beirut, Lebanon.
Ahmad M
AM
Mansour
Division of Hematology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Jong Wook
JW
Lee
Division of Hematology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Seung Ah
SA
Yahng
Department of Ophthalmology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Kyu Seop
KS
Kim
Department of Ophthalmology, Mansoura University, Mansoura City, Egypt.
Maha
M
Shahin
Oncology and Hematology Program, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil.
Nelson
N
Hamerschlak
Vision Institute, Hospital São Paulo, Federal University of São Paulo, Brazil.
Rubens N
RN
Belfort
Department of Ophthalmology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Shree K
SK
Kurup
aplastic anemia; eye; retinal hemorrhage; retinal vasculopathy; retinopathy; thrombocytopenia