An autopsy study of eye involvement in acute leukemia of childhood

The eyes of 60 children who had died of acute leukemia between 1968 and 1977 at the Children's Hospital Medical Center have been examined pathologically. An attempt has been made to relate eye findings to the state of the systemic disease at the time of death. Eight of the 60 patients had leukemic retinal infiltrates and all eight had fulminant disease with terminal leukocyte counts over 100,000 per cubic millimeter and a high percentage of "blast" cells. Twenty-six patients (43%) had leukemic infiltration of the choroid that was inapparent clinically. Choroidal involvement was not correlated with high terminal leukocyte counts but was invariably associated with widespread infiltration of other organs. Four patients had optic nerve involvement; all four had coexistent meningeal leukemia. Isolated retinal hemorrhages could not be correlated with other parameters of the leukemic process.