LAUSR

PURPOSE To evaluate the retinal circulation in patients with active acute leukemia, to correlate the perfusion metrics with systemic laboratory values, and to assess the vascular perfusion after leukemia remission. METHODS Longitudinal study of 22 eyes from 12 patients with acute leukemia; healthy eyes were recruited as controls. All patients underwent optical coherence tomography (OCTA) at baseline. OCTA was repeated in case of morphological leukemia remission. RESULTS Patients' age ranged 37-74 years. All participants had a 20/20 vision. In all leukemic eyes, OCTA detected vascular alterations in the macula and the peripapillary region. Vessel density (VD) values in the superficial capillary plexus were lower in leukemia patients than controls (46.8±3.6 vs. 49.2±2%, p=0.08), irrespective of the presence of leukemic retinopathy (7 eyes, 32%). Lower VD was associated with lower white blood cells (p=0.09) and lower platelets (p=0.001). Reappearance of small capillaries, increase in VD, reduction in vessel diameter, and increase in fractal dimension was seen after remission. CONCLUSION Subclinical, reversible reduction in vessel density and complexity on OCTA occurs in patients with active acute leukemia and is presumably associated with bone marrow function failure. Further studies are warranted to explore its functional and prognostic significance.