Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy
Abstract Background Chronic myeloid leukemia (CML) is known to cause leukemic retinopathy due to leukemia cell invasion into the choroid; however, details of the circulatory dynamics and morphological changes in the choroid are unknown. The aim of this study was to present a case of leukemic retinop...
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BMC
2022-04-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-022-02380-4 |
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| author | Mizuho Mitamura Satoru Kase Kiriko Hirooka Hiroaki Endo Yuki Ito Yuko Cho Susumu Ishida |
| author_facet | Mizuho Mitamura Satoru Kase Kiriko Hirooka Hiroaki Endo Yuki Ito Yuko Cho Susumu Ishida |
| author_sort | Mizuho Mitamura |
| collection | DOAJ |
| description | Abstract Background Chronic myeloid leukemia (CML) is known to cause leukemic retinopathy due to leukemia cell invasion into the choroid; however, details of the circulatory dynamics and morphological changes in the choroid are unknown. The aim of this study was to present a case of leukemic retinopathy and examine choroidal circulatory and structural analyses using laser speckle flowgraphy (LSFG) and optical coherence tomography with a binarization method, respectively. Case presentation A 15-year-old male diagnosed with CML complained of blurred vision in his right eye. He was ophthalmologically diagnosed with leukemic retinopathy due to retinal hemorrhage in both eyes. Tyrosine kinase inhibitors achieved complete cytogenetic remission and resolution of retinal hemorrhages at 6 months after treatment. After the treatment, the best-corrected visual acuity had recovered from 0.1 to 1.2 oculus dexter (OD) and remained at 1.5 oculus sinister (OS). The rate of change in macular blood flow assessed by the mean blur rate on LSFG was 18.3% increase OD and 25.2% decrease OS 19 months after treatment. The central choroidal thickness showed 0.4 and 3.1% reductions OD and OS, respectively. The binarization technique demonstrated that the rate of luminal areas in choroidal areas exhibited 3.2% increase OD but 4.8% decrease OS. Conclusion Choroidal blood flow improved OD after treatment for CML, while it deteriorated OS, together with choroidal thinning due to reduction of luminal areas. The degrees of leukemia cell invasion into the choroidal tissue and tissue destruction might be different between the eyes in this case. |
| first_indexed | 2024-12-21T10:24:59Z |
| format | Article |
| id | doaj.art-81418c5b239946cb8d6aa5e28d82ce0f |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-21T10:24:59Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-81418c5b239946cb8d6aa5e28d82ce0f2022-12-21T19:07:20ZengBMCBMC Ophthalmology1471-24152022-04-012211710.1186/s12886-022-02380-4Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapyMizuho Mitamura0Satoru Kase1Kiriko Hirooka2Hiroaki Endo3Yuki Ito4Yuko Cho5Susumu Ishida6Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityDepartment of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityDepartment of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityDepartment of Ophthalmology, Teine Keijinkai HospitalDepartment of Ophthalmology, Teine Keijinkai HospitalDepartment of Pediatrics, Hokkaido UniversityDepartment of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityAbstract Background Chronic myeloid leukemia (CML) is known to cause leukemic retinopathy due to leukemia cell invasion into the choroid; however, details of the circulatory dynamics and morphological changes in the choroid are unknown. The aim of this study was to present a case of leukemic retinopathy and examine choroidal circulatory and structural analyses using laser speckle flowgraphy (LSFG) and optical coherence tomography with a binarization method, respectively. Case presentation A 15-year-old male diagnosed with CML complained of blurred vision in his right eye. He was ophthalmologically diagnosed with leukemic retinopathy due to retinal hemorrhage in both eyes. Tyrosine kinase inhibitors achieved complete cytogenetic remission and resolution of retinal hemorrhages at 6 months after treatment. After the treatment, the best-corrected visual acuity had recovered from 0.1 to 1.2 oculus dexter (OD) and remained at 1.5 oculus sinister (OS). The rate of change in macular blood flow assessed by the mean blur rate on LSFG was 18.3% increase OD and 25.2% decrease OS 19 months after treatment. The central choroidal thickness showed 0.4 and 3.1% reductions OD and OS, respectively. The binarization technique demonstrated that the rate of luminal areas in choroidal areas exhibited 3.2% increase OD but 4.8% decrease OS. Conclusion Choroidal blood flow improved OD after treatment for CML, while it deteriorated OS, together with choroidal thinning due to reduction of luminal areas. The degrees of leukemia cell invasion into the choroidal tissue and tissue destruction might be different between the eyes in this case.https://doi.org/10.1186/s12886-022-02380-4Chronic myeloid leukemiaLeukemic retinopathyLaser speckle flowgraphyOptical coherence tomographyBinarization method |
| spellingShingle | Mizuho Mitamura Satoru Kase Kiriko Hirooka Hiroaki Endo Yuki Ito Yuko Cho Susumu Ishida Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy BMC Ophthalmology Chronic myeloid leukemia Leukemic retinopathy Laser speckle flowgraphy Optical coherence tomography Binarization method |
| title | Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| title_full | Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| title_fullStr | Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| title_full_unstemmed | Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| title_short | Alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| title_sort | alterations of choroidal circulation and vascular morphology in a patient with chronic myeloid leukemia before and after chemotherapy |
| topic | Chronic myeloid leukemia Leukemic retinopathy Laser speckle flowgraphy Optical coherence tomography Binarization method |
| url | https://doi.org/10.1186/s12886-022-02380-4 |
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