June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Ocular Findings In Aplastic Anemia: Multicenter Study and Literature review
Author Affiliations & Notes
  • Ramzi Alameddine
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Ahmad Mansour
    Ophthalmology, American University of Beirut, Beirut, Lebanon
    Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
  • Jong Wook Lee
    Ophthalmology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
  • Seung Ah Yahng
    Division of Hematology- Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
  • Kyu Seop Kim
    Ophthalmology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
  • Maha Shahin
    Ophthalmology, Mansoura University, Mansoura City, Egypt
  • Nelson Hamerschlak
    Oncology & Hematology Program, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
  • Rubens Belfort Neto
    Vision Institute, Hospital São Paulo, Federal University of São Paulo, São Paulo, Brazil
  • Shree Kurup
    Ophthalmology, Wake Forest University Baptist Medical Center, Winston-Salem, NC
  • Footnotes
    Commercial Relationships Ramzi Alameddine, None; Ahmad Mansour, None; Jong Wook Lee, None; Seung Ah Yahng, None; Kyu Seop Kim, None; Maha Shahin, None; Nelson Hamerschlak, None; Rubens Belfort Neto, None; Shree Kurup, Abbott (F), Allergan (F), Regeneron (F), Lux Bio (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1571. doi:
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      Ramzi Alameddine, Ahmad Mansour, Jong Wook Lee, Seung Ah Yahng, Kyu Seop Kim, Maha Shahin, Nelson Hamerschlak, Rubens Belfort Neto, Shree Kurup, ; Ocular Findings In Aplastic Anemia: Multicenter Study and Literature review. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1571.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: Aplastic anemia (AA) is rare disease with few reports on ophthalmic manifestations. Ocular findings are described in a large series along with a literature review

Methods: Retrospective case review of cases in one center, The Catholic University of Korea. A literature review is also presented from 1958 to 2010 of cases with aplastic anemia not receiving any surgical therapy with addition of cases from 4 medical centers

Results: Of 719 AA patients collected, 269 patients had eye examination among them 156 patients had funduscopy and 37 patients had retinal findings (retinal hemorrhage) (23.7%). These 37 patients were studied in detail: 7 had unilateral retinal hemorrhage and 30 had bilateral retinal hemorrhage; mean age was 37.5 years (16-69 range) with 25 men and 12 women; mean hemoglobin was 6.6 g/dl(range2.7-12.6 g/dl) and platelet count 18.8 x109/l (range4-157 x109/l); central retinal vein occlusion-like picture occurred in 9 patients and these had similar rheology to rest of subjects; optic disc edema, cotton wool spots, macular edema and dry eyes occurred in 2, 3, 5 and 3 patients respectively. The ocular findings in 200 patients in the literature with aplastic anemia included retinal hemorrhages in 56%, subhyaloid or vitreous hemorrhage in 9%, peripheral retinal vasculopathy in 5.5%, cotton-wool spots, Sjögren’s syndrome, or optic disc edema in 4% each. Prevalence of retinopathy among series of aplastic anemic patients varied from 20% to 28.3%. Retinopathy was observed in 69% of patients with concomitant severe anemia (hemoglobin level below 8 g/100ml) and severe thrombocytopenia (platelet count below 50,000/mm3)

Conclusions: Retinal hemorrhage is the commonest ocular finding as it occurs in 23.7% of AA patients in the current series. Central retinal vein occlusion-like picture is the second most frequent finding occurring in 4.5% of AA patients and its occurrence is not related to a more severe rheology. The presence of ocular findings relates to the severity of anemia and the concomitance with thrombocytopenia

Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence • 462 clinical (human) or epidemiologic studies: outcomes/complications • 461 clinical (human) or epidemiologic studies: natural history  

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