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Ana Itikawa, Luis Filipe Nakayama, Vinicius Bergamo, natasha cruz, Murilo Ubukata Polizelli, rodrigo fernandes; Frequency of ophthalmological posterior segment findings in patients with Polycythemia Vera. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1312.
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Polycythemia Vera (PV) is a rare hematological systemic disease that lead to increased blood viscosity and subsequent vascular events, such as trombosis and hemorrhages. There are scarce literature about ocular involvement in PV. This study purpose was to evaluate the frequency of ocular posterior segment findings in patients with Polycythemia Vera and correlate with systemic parameters.
We performed a cross-sectional study with patients with PV diagnosis. All patients underwent complete ophthalmological examination and posterior pole assessment . Complementary exams of posterior segment were performed through colored fundus retinography, Optic Coherence Tomography (OCT) macular, Angiography OCT and fluorescein angiography (FA)Patients of both genders were included in the study. Exclusion criteria were: means opacity making the posterior pole examination impossible, fluorescein dye allergy, pregnancy, any ophthalmologic surgery in the last 6 months, patients who didn’t accept to realize exams or disagree with the consent form.
Eleven patients (22 eyes), six participants were male (54.55%) and five were female (45.45%). In 7 eyes (31.82%) were observed isolated arteriolar tortuosity and in 10 eyes (45.45%), both venous and arterial tortuosity in fundus exam.One patient (9.09%) presented 360° peripheral pigment mobilization in both eyes with hypofluorescent blockage in corresponding areas at the fluorescein angiogram (FA).Three patients (27.27%) showed geographic hypofluorescent areas in FA, corresponding to delayed perfusion in right eye (the first eye evaluated in the exam), with no corresponding areas in fundus exam. One patient presented superior nasal chorioretinal scar in left eye (9.09%); Two (18.18%) presented choroidal nevus and two (18.18%) presented hard drusen in posterior pole.
Retina and Choroid represents a microvascular system that may be distinctly affected in PV, being the vessels tortuosity the earlier finding in fundus exam and later hemorrhages and vessels occlusion could emerged, secondary to blood viscosity increased. In our study we found high incidence of multiples posterior segment findings in those patients with chronic disease without activity. Although hemoglobin and hematocrit levels were normal posterior findings such as vascular tortuosity and hypofluorescence areas in FA could represent increased ischemic events risk.
This is a 2020 ARVO Annual Meeting abstract.
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