title: Ocular manifestations in leukemia and myeloproliferative disorders and their association with hematological parameters.
abstract: OBJECTIVE
  To study the ocular manifestations in patients diagnosed with leukemia or myeloproliferative disorders and to derive an association between the ocular manifestations and hematological parameters of the patients.
  
  
  METHODS
  This observational and descriptive study was conducted in a Tertiary Care Center of Dehradun, North India over a period of 1 year. All the diagnosed cases of leukemia and myeloproliferative diseases attending the Oncology Department were included. Patients underwent a detailed ocular examination. The hematological parameters were also recorded including hemoglobin (Hb), total leukocyte count (TLC), and platelet count.
  
  
  RESULTS
  The study included 102 patients out of which, there were 66 males (64.7%), and 36 were females (35.3%) with an age range of 5-80 years. A total of forty patients showed ocular manifestations (39.3%). Extraocular manifestations were seen in 10.8% patients while intraocular manifestations were noted in 45.1% patients of acute leukemia and 7.7% patients of chronic leukemia. These ocular manifestations showed a significant association with low Hb (P = 0.000), raised TLC (P = 0.004), and low platelet count (P = 0.000). The most common ocular manifestation was intraretinal hemorrhages followed by roth spots. Among acute myeloid leukemia patients (23.5%), the presence of intraretinal hemorrhages was significantly associated with low Hb (Mann-Whitney U-test = 25.000, P = 0.007). The patients of acute lymphoblastic leukemia (25.4%) showed significant association between intraretinal hemorrhages and low platelet count (Mann-Whitney U-test = 44.000, P = 0.046) and roth spots with low Hb (Mann-Whitney U-test = 11.000, P = 0.000). Ocular manifestations were more commonly seen in acute leukemias as compared to chronic leukemias.
  
  
  CONCLUSIONS
  Ocular examination is recommended in all leukemic patients as ocular manifestations may go unnoticed, most patients being asymptomatic and could be an early sign of worsening of disease.
authors.affiliation: Department of Ophthalmology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Dhasmana
authors.affiliation: Department of Ophthalmology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
authors.forename: Amrita
authors.initials: A
authors.lastname: Prakash
authors.affiliation: Department of Ophthalmology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
authors.forename: Neeti
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Medicine, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000453:epidemiology; D012164:Retinal Diseases / Q000453:epidemiology* / Q000209:etiology; D062606:Tertiary Care Centers; D055815:Young Adult