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 (23.7percent) 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 24.8percent of subjects, retinal hemorrhage in 37percent of subjects, and any bleeding site (eye or elsewhere) occurred in 47.5percent of subjects with AA. A literature review (1958-2010) of 200 AA cases revealed retinal hemorrhages in 56percent, subhyaloid or vitreous hemorrhage in 9percent, peripheral retinal vasculopathy in 5.5percent, and cotton-wool spots, Sjögren's syndrome, or optic disc edema in 4percent each. The prevalence of retinopathy among series of AA patients varied from 20percent to 28.3percent, which is consistent with the Korean series of 24.8percent. Management of AA patients needs to involve multiple specialties, including hematologists, ophthalmologists, and infectious disease specialists. © 2014 Mansour et al.