RETINAL FINDINGS IN ADULT LEUKEMIA - CORRELATION WITH LEUKOCYTOSIS

The associations between retinal findings and haematological parameter s in acute leukaemia are controversial. Sixty-three newly-diagnosed ac ute leukaemia patients, aged 12-77 years, were studied prospectively f or the presence of intra-retinal haemorrhages (IRH), white-centred hae morrhages (WCH), cotton wool spots (CWS) and macular haemorrhages (MH) . Thirty-three patients (52.4%) showed at least one retinal abnormalit y. The prevalence of individual findings was: IRH (30 cases), WCH (20 cases), CWS (5 cases), MH (11 cases). In contrast to previous studies, there was no association between any of these retinal findings and th e haemoglobin level or the platelet count. There was a higher median W BC in patients with IRH (68 x 10(9)/l) than in those without IRH (15.4 x 10(9)/l), P = 0.037. When the acute myeloblastic leukaemia cases we re considered separately, an association was also found between higher WBC and the presence of WCH and CWS. There was no association between retinal findings and FAB type in the AML cases. We conclude that a hi gh WBC may be at least as important as anaemia and thrombocytopenia th e pathogenesis of the retinopathy of acute leukaemia.