Study of Retinal and Peripapillary Vascular Changes in Newly Diagnosed Acute Leukemic Patients Using Optical Coherence Tomography Angiography

Abstract Background Leukemia is a neoplastic blood disorder characterized by an abnormal proliferation of leukocytes. Knowledge of ocular involvement in leukemia is important because the eye is the only site where the leukemic involvement of nerves and blood vessels can be directly observed, because the eye symptoms may be the initial mode of presentation of the systemic illness. Almost all ocular structures have been found to be involved in patients with various types of leukemia. Objective To detect retinal and peripapillary vascular changes in newly diagnosed acute leukemic patients prior to chemotherapy treatment using optical coherence tomography angiography. Patients and Methods This comparative cross sectional study was carried out on 52 eyes of 26 patients and 52 eyes of 26 healthy subjects. Optical coherence tomography angiography was performed for all subjects. Central macular thickness. Retinal nerve fiber layer thickness, ganglion cell complex thickness, superficial and deep vessel density, foveal avascular zone area and radial peripapillary capillaries density were measured and analyzed. Results Significant decrease in the superficial capillary plexus and the radial peripapillary capillary density in the cases group. The FAZ area is larger in the cases group. The central macular thickness is lower in the cases group. But the RNFL thickness, and C/D parameters were higher in the case group. However, there was no significant difference between the two groups regarding the GCC and the DCP density. Conclusion Acute leukemia causes decrease in superficial capillary plexus density and radial peripapillary capillaries density and decreased macular thickness with no affection in deep capillary vessel density.