OCULAR MANIFESTATIONS IN PATIENTS WITH LEUKEMIA AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, NIGERIA: A CASE CONTROL STUDY
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Keywords

Leukaemia, ocular disorders, ophthalmopathy, proptosis, haemorrhage

Abstract

Aim: To evaluate the frequency and types of ocular manifestations of leukaemia in University of Benin Teaching Hospital, Nigeria.
Method: This is a hospital- based case control study from September 2014 to April 2015. Forty newly diagnosed leukaemic patients were enrolled into the study. Age and sex matched controls were drawn from healthy relatives of patients, staff and students of University of Benin and children of University of Benin Staff School. They had Full Blood Count, Genotype, Fasting blood sugar and other tests done to exclude confounding factors such as diabetes mellitus, HIV and hypertension. All the study subjects were interviewed and had detailed ocular examination. Refraction was done where necessary. Clinical data from each individual was obtained using interviewer administered questionnaires. These were collated and analyzed using SPSS 20.
Results: A total of 160 eyes of 80 subjects were examined. There were forty new patients (cases) with leukaemia and forty controls. The age range for cases was 3 to 78 years with a mean age of 43.28 +21.48 years while the mean age for the controls was 43.30 +21.26 years. The male to female ratio was 1.35:1 with23 (57.5%) males and 17 (42.5%) females. There were 31 (77.5%) adults and 9 (22.5%) children. There were13 (32.5%) acute and 27 (67.5%) chronic leukaemia comprising of 4 (10.0%) acute myelocytic leukaemia, 9 (22.5%) acute lymphocytic leukaemia, 11 (27.5%) chronic myeloid leukaemia and 16 (40.0%) chronic lymphocytic leukaemia. Ocular leukaemic disorders were present in 12 (30.0%) patients. The leading leukaemic related anterior segment disorders were conjunctival pallor 18 (22.5%) followed by subconjunctival haemorrhage 12 (15.0%) and proptosis 7 (8.8%), while the leading leukaemic posterior segment disorders were intraretinal haemorrhage 13 (16.3%) followed by retinal infiltrates, venous dilatation and tortuosity 8 (10.0%) each. The eye changes were seen more often in adults 22 eyes (35.5%) than in children 2 eyes (11.1%) and in myeloid leukaemia than in lymphoid leukemia.
Conclusion: Leukaemic ophthalmopathy occurs in patients living with leukaemia, some of which are potentially blinding disorders. The frequency of these ocular disorders was significant among the cases studied.

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