Retinopathy in blood diseases

Retinopathies in anemia

Anemia refers to a group of blood disorders characterized by a decrease in the volume of circulating red blood cells and / or hemoglobin. Retinal changes in anemia usually occur without consequences, rarely present a diagnostic value.

Retinopathy is characterized by hemorrhages, sometimes with a white spot in the center (Roth stains, cotton-like foci and crimp branches).

Duration and type of anemia do not affect the appearance of these changes, which are more characteristic of concomitant thrombocytopenia.

Hemorrhages in the form of "flame tongues" and vata-like foci can appear in the absence of other blood anomalies.

The tortuosity of the veins depends on the severity of the anemia. Roth spots are represented by fibrinous thrombi blocking vascular ruptures. They can be found in bacterial endocarditis and leukemia.

Optical neuropathy with central scotomas can occur with pernicious anemia. If the patient is not treated with drugs containing vitamin B12, persistent atrophy of the optic nerve develops. Pernicious anemia can cause dementia, peripheral neuropathy and subacute combined degeneration of the spinal cord with damage to the posterior and lateral cord.

Retinopathies in leukemia

Leukemia is classified as a group of neoplastic changes characterized by the proliferation of white blood cells. The defeat of the eye is often noted in acute form, less often in chronic, with possible involvement of different structures of the organ of vision. However, it is important to distinguish rather rare infiltration phenomena in primary leukemias from more frequent secondary changes associated with anemia, thrombocytopenia, increased viscosity and opportunistic infections.

Retinopathy is relatively common. The changes are similar to anemia with hemorrhages in the form of "tongues of flame", spots Roth, cotton-like foci. The latter may be due to leukemia infiltration, or secondary anemia or increased viscosity. Peripheral retrovascular retrovascularisation is a frequent manifestation of chronic myeloid leukemia. More rarely, as a result of secondary choroidal infiltration, the development of leukemic pigment epitheliopathy, known as "leopard spots" on the fundus, is possible.

Other eye manifestations

• Involvement of the orbit, more often in children.
• Thinning of the iris, iritis and pseudohyping.
• Spontaneous subconjunctival hemorrhage or hyphema.
• Optical neuropathy caused by infiltration of the optic nerve.

The states of high blood viscosity

The states of increased viscosity are attributed to a group of diverse rare disorders characterized by an increase in blood viscosity due to polycythemia or abnormal plasma proteins, such as in Waldenstrom macroglobulinemia and myeloma. Retinopathy is manifested by the expansion of veins, segmentation and tortuosity, hemorrhages of the retina.