Non-invasive imaging of retinal blood flow in myeloproliferative neoplasms.
OBJECTIVE
To study the circulation in the retinal vessels in patients with blood dyscrasia due to myeloproliferative neoplasms using non-invasive retinal imaging.


METHODS
Prospective consecutive case series of seven treatment-naïve patients with chronic myeloid leukaemia (n = 2), polycythemia vera (n = 4), essential thrombocytosis (n = 1) examined before and after cytoreductive treatment. We investigated retinal circulation with motion-contrast imaging, retinal oximetry and spectral-domain optical coherence tomography.


RESULTS
Retinal venous blood velocity increased by 8.14% (CI953.67% to 12.6%, p = 0.004) and retinal arterial oxygen saturation increased by 7.23% (CI952.9% to 11.6%, p = 0.010) at follow-up (mean 12 weeks, range 5-14 weeks) where complete haematological remission had been achieved by cytoreductive treatment. Abnormal optical coherence tomography reflectivity patterns were present at baseline in patients with chronic myeloid leukaemia and were replaced by normal patterns at follow-up. Retinopathy, in the form of cotton-wool spots and retinal haemorrhages, was found at presentation in the two patients with chronic myeloid leukaemia and in one patient with polycythemia vera. The retinopathy had resolved at follow-up in all patients.


CONCLUSIONS
With non-invasive retinal imaging, we were able to demonstrate increased retinal venous blood velocity, increased retinal arterial blood oxygenation and normalization of intravascular reflectivity patterns after successful treatment of myeloproliferative neoplasms. Larger prospective studies are needed to assess the prognostic value of these non-invasive imaging methods in predicting circulatory complications in myeloproliferative neoplasms.
Department of Ophthalmology, Glostrup Hospital and Rigshospitalet, Glostrup, Denmark.
Anne
A
Willerslev
Department of Ophthalmology, Glostrup Hospital and Rigshospitalet, Glostrup, Denmark.|Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Mathias M
MM
Hansen
Department of Ophthalmology, Glostrup Hospital and Rigshospitalet, Glostrup, Denmark.|Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Oliver Niels
ON
Klefter
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Ole Weis
OW
Bjerrum
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Hematology, Roskilde Hospital, Roskilde, Denmark.
Hans C
HC
Hasselbalch
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Stine N
SN
Clemmensen
Department of Ophthalmology, Glostrup Hospital and Rigshospitalet, Glostrup, Denmark.|Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Michael
M
Larsen
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
Inger Christine
IC
Munch
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology*; D012171:Retinal Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult
blood dyscrasia; motion-contrast imaging; non-invasive retinal imaging; retinal blood flow; retinal oximetry; spectral-domain optical coherence tomography