Ocular manifestations of idiopathic aplastic anemia: retrospective study and literature review

摘要

Abstract: Aplastic anemia (AA) is a rare disease with few reports on its ophthalmic -manifestations. The ocular findings are described in a retrospective consecutive series of?719?AA Korean patients followed at the Hematology Clinic of The Catholic University of Korea. Out of a total of?719?patients,?269?patients had eye examinations,?156?patients had retinal evaluation, and?37?(23.7%) had retinal findings. These?37?patients had unilateral retinal -hemorrhage in seven and bilateral retinal hemorrhage in?30?with mean hemoglobin of?6.6?g/dL (range?2.7–12.6?g/dL) and platelet counts of?18.8×109/L (range?4–157×109/L); central retinal vein occlusion-like picture occurred in nine patients and these had similar rheology to the rest of the subjects; optic disc edema, cotton-wool spots, macular edema, and dry eyes occurred in two, three, five, and three patients, respectively. In this Korean series of?141?subjects with AA, systemic bleeding occurred in?24.8% of subjects, retinal hemorrhage in?37% of subjects, and any bleeding site (eye or elsewhere) occurred in?47.5% of subjects with AA. A literature review (1958–2010) of?200?AA cases revealed retinal hemorrhages in?56%, subhyaloid or vitreous hemorrhage in?9%, peripheral retinal vasculopathy in?5.5%, and cotton-wool spots, Sj?gren’s syndrome, or optic disc edema in?4% each. The prevalence of retinopathy among series of AA patients varied from?20% to?28.3%, which is consistent with the Korean series of?24.8%. Management of AA patients needs to involve multiple specialties, including hematologists, ophthalmologists, and infectious disease specialists.