OVERVIEW
OVERVIEW
Leukemic retinopathy is a fundus change caused by extensive infiltration of the retina by large numbers of leukemic cells.
Is it covered by Medicare?
Yes
Department
Hematology, Ophthalmology
Clinical symptoms
Loss of vision, in severe cases there may be narrowing of the visual field and night blindness.
Hazards
Loss of vision, seriously affecting daily life.
Complications
Anemia, thrombocytopenia, etc.
Examination
Blood routine, urine routine, bone marrow examination, fundus examination, histopathological examination, CT, MRI, fluorescence angiography, etc.
Diagnosis
Diagnosis can be made based on the history of leukemia and fundus examination.
Treatment principle
Chemotherapy and symptomatic supportive therapy, ocular symptoms can be localized radiation therapy.
Curability
Symptoms can be relieved with treatment.
Dietary recommendations
Fine, soft, easily digestible food.
Etiology
Etiology
Leukemia triggered by genetic factors, exposure to chemicals, radiation effects, and biological factors (e.g., viral infections).
Symptoms and Diagnosis
Typical Symptoms
Retinal vascular changes venous tortuous filling, tube diameter can be enlarged to several times the normal, arteriovenous tube diameter ratio can be 1:2 or even 1:4, especially at the intersection of arteriovenous obvious. Retinal hemorrhage and exudationRetinal hemorrhage accounts for the second largest number of fundus lesions in leukemia, especially in the acute type. Retinal and choroidal infiltration Due to the infiltration of leukemia cells in the retina and choroid, retinal edema can be produced, and the color of the retina changes from normal orange-red to orange, or even yellow-white. Optic disk edema Leukemic lesions may invade different parts of the optic nerve. If the leukemic cells infiltrate before the sieve plate, they may blur the boundaries of the optic disk, and the optic disk edema may be as high as several diopters, accompanied by hemorrhage.
Diagnosis is based on
History of leukemia. Decreased visual acuity, and in severe cases, visual field reduction and night blindness. Funduscopic examination reveals that the retinal veins are full, dark, and curved and irregularly dilated, especially at the intersection of the arteries and veins; retinal hemorrhage may occur in any part of the retina; and the optic disc may be mildly edematous.
Treatment
Treatment guidelines
Chemotherapy and symptomatic supportive therapy, localized radiation therapy for ocular symptoms.
Drug therapy
Mainly systemic treatment, only symptomatic treatment for ocular symptoms.
Radiotherapy
Systemic chemotherapy with cyclophosphamide, methotrexate, cytarabine and vincristine. Timely localized radiation therapy when there are symptoms in the eye to preserve vision.
Prognosis
Symptoms can be relieved with reasonable treatment.
Nursing care
Daily care
Keep warm and avoid catching cold. Keep the living environment with fresh air and disinfect it regularly. Pay attention to personal hygiene, especially keep the mouth and vulva clean. Pay attention to rest, avoid strenuous activities, and pay attention to the combination of work and rest. Reduce contact with the outside world and unnecessary visits.
Dietary modification
Do not eat overnight food. Eat more fresh vegetables and fruits. Acute leukemia patients because of chemotherapy and other reasons lead to their own neutrophils are relatively low, easy to infection, the diet should be as clean as possible. Patients with low platelets are recommended to eat soft food, do not eat fish bones and other foods that can easily lead to oral mucosal rupture. Drink plenty of warm boiled water. This is due to the destruction of a large number of white blood cells, especially in chemotherapy, the concentration of uric acid in the serum and urine increases, accumulates in the renal tubules, easy to cause obstruction and uric acid nephropathy. Avoid smoking, alcohol, spicy, fried, grilled and other foods.