中国斜视与小儿眼科杂志2017，Vol.25Issue(4)：23-24,后插1-后插2,4.DOI:10.3969/J.ISSN.1005-328X.2017.04.008
儿童急性淋巴细胞白血病合并眼底病变的临床观察
Clinical analysis of Children with Acute Lymphoblastic Leukemia and fundus change
王建仓 1杜非凡 1田海霞 1郑微 1苏鸣 1郭熙婷1
作者信息
- 1. 050000 石家庄,河北省儿童医院眼科
- 折叠
摘要
Abstract
Objective To investigate types of fundus change in children with acute lymphoblastic leukemia and clinical features of each type, providing the clinical basis for differential diagnosis and timing of treatment. Methods Retrospective case study. The clinical data of 24 patients (39 eyes) with acute lymphoblastic leukemia and clinical features were collected from January 2015 to September 2017. Slit-lamp ophthalmoscopy,indirect oph-thalmoscopy, fundus photography, blood CMV-IgM, blood CMV-DNA, urine CMV-DNA, and T-lymphocyte counts when the lesion changes were measured. Results 39 eyes of 24 patients are reviewed,including 15 males 25 eyes,9 females 14 eyes. The age ranges from 3 to 14 years,the mean age was (7.88±2.61) years old. In-cluding 11 cases 17 eyes (45.83%) of cytomegalovirus retinitis and 13 cases 22 eyes (54.17%) of leukemic retinopathy were included,fundus changes were the first manifestation in 4 cases. All the cytomegalovirus retinitis patients CD4+ T lymphocyte were less than 200 cells/μl. Temporal peripheral lesions are most common,the majori-ty of lesion were quiescence after treatment following with increase of CD4+ T lymphocyte count, more than 200 cells/μl. Bilateral optic disc edema appear in 45.45% of leukemic retinopathy, 36.36% has retinal hemorrhage, 18.18% has both. The prognosis was good after treatment in department of hematology. Conclusions There are vari-ous types of fundus changes in children with acute lymphoblastic leukemia and need to be identified, cy-tomegalovirus retinitis should be notice except of leukemic retinopathy. The progression of cytomegalovirus retinitis is closely related to the decrease in T-lymphocyte counts. For DNA positive and CD4+ T lymphocyte reductions, especially in patients with less than 200 cells/μl, cytomegalovirus retinitis should be highly suspected. The prognosis of fundus disease caused by leukemia is better.关键词
儿童/急性淋巴细胞白血病/眼底病变Key words
Children/Acute lymphoblastic leukemia/Fundus change引用本文复制引用
王建仓,杜非凡,田海霞,郑微,苏鸣,郭熙婷..儿童急性淋巴细胞白血病合并眼底病变的临床观察[J].中国斜视与小儿眼科杂志,2017,25(4):23-24,后插1-后插2,4.
