Ocular involvement in patients with leukemia may manifest as fundus retinal hemorrhage, orbital infiltration, spontaneous subconjunctival hemorrhage in the anterior segment of the eye, and corneal ulceration and vitreous clouding, usually as a sign of poor prognosis.
The fundus examination in patients with leukemia has the following implications:
- To clarify the presence or absence of leukemic cell infiltration in the fundus;
- To clarify the presence of combined fundus hemorrhage, which is often seen as a precursor to intracranial hemorrhage;
- When a patient is suspected of having intracranial hemorrhage or cerebral white due to headache or vomiting, examination of the fundus can help to determine whether the patient has elevated intracranial pressure through changes in the optic papilla, which is often a life-threatening emergency and requires prompt treatment such as dehydration and lowering of cranial pressure.
Dr. Wang Junying of the Department of Hematology at Shanghai Renji Hospital South also contributed to this Q&A
.