Ophthalmic manifestations of leukemia in a tertiary hospital population of adult Nigerian Africans

Abstract

Purpose: To determine the prevalence and pattern of leukemic ophthalmopathy among adults at the University of Nigeria Teaching Hospital (UNTH), Enugu, south-eastern, Nigeria. Materials and Methods: This prospective, observational case series surveyed adult leukemia patients presenting at UNTH's departments of Hematology/Immunology and Ophthalmology from July 2003 to August 2008. The demographic profile, clinical data from for each individual in the cohort were statistically collated and analyzed. A P <0.05 was considered as statistically significant. Results: There were 72 participants (45 males and 27 females), aged 32.7 +- 9.8 years (range, 18 years to 72 years). Leukemic ophthalmopathy was present in 77.8% of subjects. The leading ophthalmic manifestations of leukemia were retinal vascular abnormalities in 50.0% of subjects, conjunctival pallor in 27.8% of subjects, sub-conjunctival hemorrhage in 19.4% of subjects, and retinal hemorrhage in 16.7% of subjects. Ocular co-morbidity was present in 47.2% of subjects. Vision loss occurred in 37.5% of subjects, of which 32.1% was leukemia related, and the remaining due to ocular co-morbidity. Leukemic ophthalmopathy was more prevalent in chronic leukemia (P <0.05), frequently affected the ocular posterior segment (P < 0.05), and often resulted from secondary hematologic complications (P <0.05). There was no gender difference in the prevalence of leukemia (P = 0.0822) or leukemic ophthalmopathy (P = 0.6624). Conclusion: The prevalence of leukemic ophthalmopathy in Enugu is high. It is often associated with significant ocular co-morbidity and vision loss. These have implications for clinicians involved in leukemia management. Early diagnosis and regular ophthalmic examinations are recommended to optimize treatment outcomes.