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Observational Study
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World J Exp Med. Mar 20, 2026; 16(1): 111034
Published online Mar 20, 2026. doi: 10.5493/wjem.v16.i1.111034
Acute childhood leukemia and ophthalmic manifestations: An observational study from Eastern India
Sucheta Parija, Shanmugasundaram Palanisamy
Sucheta Parija, Shanmugasundaram Palanisamy, Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneshwar 751019, Odisha, India
Co-corresponding authors: Sucheta Parija and Shanmugasundaram Palanisamy.
Author contributions: Parija S contributed to concept, analysis, writing and editing of article; Palanisamy S contributed to data collection, Statistical analysis, proofreading and editing; Parija S and Palanisamy S have played important and indispensable roles in the manuscript preparation as the co-corresponding authors.
Institutional review board statement: Ethical approval was obtained from the All India Institute of Medical Sciences.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: No data shared.
Corresponding author: Sucheta Parija, Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Sujia, Patrapada, Bhubaneshwar 751019, Odisha, India. suchetaparija@yahoo.com
Received: June 24, 2025
Revised: August 14, 2025
Accepted: January 6, 2026
Published online: March 20, 2026
Processing time: 266 Days and 19.9 Hours
Abstract
BACKGROUND

The ocular manifestations in acute leukemia can occur due to primary leukemic infiltration or secondary to the disease and chemotherapy complications. As the life expectancy has increased in leukemia cases due to the advent of modern chemotherapy, the incidence of ocular features is more evident.

AIM

To describe the clinical pattern of ocular manifestations at the time of diagnosis of acute leukemia in children.

METHODS

This was a hospital-based, cross-sectional study conducted at a tertiary care academic Institute in eastern India between July 2016 to December 2019. All children below 15 years diagnosed with acute leukemia underwent a comprehensive eye checkup before initiation of chemotherapy. The demographic details, type of leukemia, hematological findings, and chemotherapy regimen were documented.

RESULTS

Among the 47 children diagnosed with acute leukemia only 19 cases (40.4%) had ocular involvement. There were 33 boys (70.2%) and 14 (29.8%) girls. Ocular involvement was more common in lymphoblastic leukemia in our study in 13 cases [39.4%; 11 B-acute lymphoblastic leukemia (B-ALL), 2 T-ALL] than in myeloid leukemia in 6 cases (42.9%). The most common manifestation was leukemic retinopathy mainly intraretinal hemorrhages in 12 cases (25.5%; B-ALL-10, and T-ALL-2).

CONCLUSION

Ophthalmological manifestations are more common in ALL patients (39.4%). Periodic ophthalmic evaluations of all patients must be made to detect ocular findings in asymptomatic cases. Early detection, risk stratification, and regular follow-up are also needed.

Keywords: Acute paediatric leukaemia; Leukaemia subtypes; Ocular involvement; Leukemic retinopathy; Intraretinal hemorrhages; Chemotherapy

Core Tip: This study was undertaken to analyze the ocular features of cases of acute leukemia in children. Most of the cases are asymptomatic at presentation and can manifest with vision-threatening features in the form of vitreous hemorrhage and subhyaloid hemorrhage in the posterior pole, which needs immediate treatment. Hence, periodic ocular examinations are needed.