Acute childhood leukemia and ophthalmic manifestations: An observational study from Eastern India

The ocular manifestations in acute leukemia can occur due to primary leukemic infiltration or secondary to the disease and chemotherapy complications. As the life expectancy has increased in leukemia cases due to the advent of modern chemotherapy, the incidence of ocular features is more evident.

To describe the clinical pattern of ocular manifestations at the time of diagnosis of acute leukemia in children.

This was a hospital-based, cross-sectional study conducted at a tertiary care academic Institute in eastern India between July 2016 to December 2019. All children below 15 years diagnosed with acute leukemia underwent a comprehensive eye checkup before initiation of chemotherapy. The demographic details, type of leukemia, hematological findings, and chemotherapy regimen were documented.

Among the 47 children diagnosed with acute leukemia only 19 cases (40.4%) had ocular involvement. There were 33 boys (70.2%) and 14 (29.8%) girls. Ocular involvement was more common in lymphoblastic leukemia in our study in 13 cases [39.4%; 11 B-acute lymphoblastic leukemia (B-ALL), 2 T-ALL] than in myeloid leukemia in 6 cases (42.9%). The most common manifestation was leukemic retinopathy mainly intraretinal hemorrhages in 12 cases (25.5%; B-ALL-10, and T-ALL-2).

Ophthalmological manifestations are more common in ALL patients (39.4%). Periodic ophthalmic evaluations of all patients must be made to detect ocular findings in asymptomatic cases. Early detection, risk stratification, and regular follow-up are also needed.