Changes in blood flow velocity and thickness of the choroid in a patient with leukemic retinopathy

Choroidal circulation hemodynamics in eyes with leukemia has not been quantitatively examined yet. We quantitatively examined changes in choroidal blood flow velocity and choroidal thickness at the macula by using laser speckle flowgraphy (LSFG) and enhanced depth imaging optical coherence tomography (EDI-OCT) in a patient with leukemic retinopathy.

A 15-year-old boy presented with sudden central vision loss of his right eye. The patient's best-corrected visual acuity was 0.09 OD and 1.2 OS. Funduscopy revealed a sub-inner limiting membrane hemorrhage at the macula, intra-retinal hemorrhages with Roth spots, and dilatation and tortuosity of retinal veins OU. Leukocytosis with the Philadelphia chromosome was found in the peripheral blood, which led to a diagnosis of retinopathy associated with chronic myeloid leukemia. Retinal hemorrhages resolved after chemotherapy. Macular mean blur rates on LSFG increased by 24-38% OD and 13-26% OS, while macular choroidal thicknesses on EDI-OCT decreased by 7-60 μm OD and 8-46 μm OS during the 3-month follow-up period after the start of treatment.

These results suggest that choroidal blood flow velocity decreased and choroidal thickness increased sub-clinically in the acute stage of a patient with leukemic retinopathy. LSFG and EDI-OCT may be useful to non-invasively evaluate the activity of choroidal involvement in leukemic retinopathy.