Abstract
Purpose :
To use multimodal ocular imaging techniques in analyzing circulatory consequences, and changes in retinal vessels in patients with hematological disorders.
Methods :
Prospective observational study of 13 patients with blood dyscrasia (chronic myeloid leukemia (n=3), essential thrombocytosis (n=3), polycythemia vera (n=4), acute myeloid leukemia (n=1), splenic marginal zone lymphoma (n=1), secondary erythrocytosis (n=1)) and 13 healthy subjects. All patients underwent a minimum of two examinations at different stages of disease. Examinations included assessment of best-corrected visual acuity, fundus photography, optical coherence tomography (OCT), retinal vessel calibers and wall-lumen ratios, and retinal capillary blood flow velocity.
Results :
Higher degrees of blood dyscrasia were associated with higher density of retinal hemorrhage, in 2/13 patients, higher vessel tortuosity, in 4/13 patients, abnormal intravascular OCT reflectivity, and abnormal OCT signal attenuation patterns. State of more normal blood parameters was associated with a 18% increase, in linear capillary perfusion velocity in the macula (p=0.01).
Conclusions :
In patients with a heterogeneous array of blood disorders, the identification of conventional disease markers, such as retinal hemorrhages and venous congestion, was supplemented by new quantitative markers in the form of intravascular optical reflectivity patterns, vessel diameters and retinal perfusion velocities. Such methods of clinical investigation may be of value in the clinical diagnosis and management of disease. and in the definition of thresholds of intervention based on the detection of adverse microvascular effects. While a deeper analysis of pathophysiology will rely on a multimodal methodological approach, simpler implementation can be foreseen in routine fundus imaging and OCT settings.
This is a 2021 Imaging in the Eye Conference abstract.