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ARTICLES
Year : 1983  |  Volume : 31  |  Issue : 7  |  Page : 899-902

The fundus findings in blood dyscrasias


Regional Institute of Ophthalmology, M.J. Hospital Ahmedabad, India

Correspondence Address:
V C Kataria
Regional Institute of Ophthalmology, M.J. Hospital Ahmedabad
India
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Source of Support: None, Conflict of Interest: None


PMID: 6544283

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How to cite this article:
Kataria V C, Audich K L, Narang S K, Khamar B M. The fundus findings in blood dyscrasias. Indian J Ophthalmol 1983;31, Suppl S1:899-902

How to cite this URL:
Kataria V C, Audich K L, Narang S K, Khamar B M. The fundus findings in blood dyscrasias. Indian J Ophthalmol [serial online] 1983 [cited 2020 May 26];31, Suppl S1:899-902. Available from: http://www.ijo.in/text.asp?1983/31/7/899/29700

Table 9

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Table 9

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Table 2

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Table 2

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Table 1

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Table 1

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The retina is the great meetting place bet­ween Ophthalmology and general medicine. So in many systemic conditions, fundus examination helps in the diagnosis and/or prognosis of the condition.

This study describes the fundus changes in patients with blood dyscrasias and attempts to answer as to about their incidences, their relationship with the different factors like blood count and their diagnostic as well as prognostic importance.


  Materials and methods Top


Astudy of 100 patients ofvarious types and forms of the blood dyscrasias was done, when they attended M.P. Shah Cancer Hospital, Ahmedabad, or Civil Hospital, Ahmedabad.

The detailed history was taken general and ocular examinations were carried out. All the necessary investigations were done.

The pupils were dilated and direct as well as indirect ophthalmoscopic examinations were done. Note was made of any abnor­malities in media, appearance of disc and blood vessels and of the presence and haemorrhages and exudates. Whenever poss­ible, the retinal abnormalities were photo­graphed.


  Observations Top


The proportion of patients with retinal abnormalities in each group is shown in [Table - 1] out of 100 patients. 50% are of leukemias, 40% are of all types of anemias and remaining 10% are of leukopenia, purpura, polycythaemia and hemophilia. It shows that all types of leukaemia constitute a major group in various types of blood dyscrasias and next is anaemia.

The higher incidence of retinal haemor­rhages is seen in leukaemia while the pallor of disc is seen more commonly in anaemias.

Anaemias: Only 6 out of 40 patients had retinopathy and all these were severely anaemic. But the appearance of pale disc was seen in 18 patients. It seems that severely anaemic patients with Hb less than 3 gm% and R.B.Cs. count less than 2 million/cmm were more likely to develop fundus changes.

The retinal abnormalities were invariably cleared on treatment.

[Table - 5][Table - 6][Table - 7][Table - 8][Table - 9] show comparison of Hb cone, platelet count, blast cells and W.B.C. count with retinal changes in patients of acute and chronic leukaemias. The number in brackets indicating no. of patients having retinal lesions.

Acute Leukaemias:

Eighteen out of 33 patients had a retino pathy. The retinal abrnomalities showed no distinguishing features. All the patients were having flame shaped and discrete haemorr­hages and 3 developed subyhyaloid haemorrhages. The haemorrhages in a num­ber of patients had white centres, but these were not related to a high total white cell count.

As shown in [Table - 5][Table - 6][Table - 7][Table - 8] retino­pathy was observed when the patients were more anaemic and had a lower platelet count and a higher percentage of circulating blast cells. No significant correlation between the presence of retinopathy and the W.B.C. count could be established.

The survival of patients with retinal abnor­malities did not differ significantly from those in whom the fundus oculi was consistently normal.

Chronic Leukaemias:

Ten out of sixteen patients were having retinal haemorrhages and dilated tortuous veins. The presence of retinopathy did not depend upon the platelet count or white blood cell count but occurred at a lower Hb. concen­tration. The prognosis of patients with retinopathy was no worse than that of those without it.

Other Blood Diseases:

The number of other cases being very less no definite conclusion can be drawn. But the observations were that:­

a) In Leukopenias and hemophilia retino­pathy is rare.

b) While in polycythaemia retinal haemorr­hages are common.

c) Retinopathy occurs more frequently when platelet count is less than 1 lac/cmm and Hb less than 3 gm%.


  Summary Top


The fundus oculi of 100 patients with blood diseases seen at the M.P. Shah Cancer Hospi­tal, Ahmedabad and a Civil Hospital, Ahmedabad, were carefully examined in

order (a) to define the incidence of retino­pathy in various disorders of blood, (b) to determine the diagnostic and/or prognostic importance of lesions seen and (c) to relate the abnormalities found to the blood count.

Retinal haemorrhages were more common in lenkaemias, while the pale disc was the uni­que feature of severe anaemias. The retinal abnormalities had no characteristics of diagnostic and/or prognostic significance.



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8], [Table - 9]



 

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