Ghosh D. Letter to the Editor: Eye as a window to disease burden in pediatric acute leukemia. World J Exp Med 2026; 16(2): 119334 [DOI: 10.5493/wjem.v16.i2.119334]
Corresponding Author of This Article
Devlina Ghosh, PhD, Assistant Professor, Department of Biochemistry, Saraswati Dental College & Hospital, 233 Tiwariganj, Ayodhya Road, Lucknow 226028, Uttar Pradesh, India. ghoshdevlin6@gmail.com
Research Domain of This Article
Ophthalmology
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letter
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Ghosh D. Letter to the Editor: Eye as a window to disease burden in pediatric acute leukemia. World J Exp Med 2026; 16(2): 119334 [DOI: 10.5493/wjem.v16.i2.119334]
World J Exp Med. Jun 20, 2026; 16(2): 119334 Published online Jun 20, 2026. doi: 10.5493/wjem.v16.i2.119334
Letter to the Editor: Eye as a window to disease burden in pediatric acute leukemia
Devlina Ghosh
Devlina Ghosh, Department of Biochemistry, Saraswati Dental College & Hospital, Lucknow 226028, Uttar Pradesh, India
Author contributions: Ghosh D designed the overall concept and outline of the manuscript, contributed to the discussion and design of the manuscript, and contributed to the writing and editing of the manuscript, illustration, and review of the literature; and author has read and agreed to the submitted version of the manuscript.
AI contribution statement: The online available AI tools are only used for syntax correction. All or any part of the manuscript body (abstract, introduction, materials and methods, results, discussion, and conclusion) is not generated by AI. I have not used AI tools for translation. There is no data generation/analysis as this is a letter to the editor. After the manuscript is completed, the available online AI tools are only used for grammar correction. I confirm that the image is original and was created by the author using Biorender.
Conflict-of-interest statement: The author declares that there are no conflicts of interest related to this work.
Corresponding author: Devlina Ghosh, PhD, Assistant Professor, Department of Biochemistry, Saraswati Dental College & Hospital, 233 Tiwariganj, Ayodhya Road, Lucknow 226028, Uttar Pradesh, India. ghoshdevlin6@gmail.com
Received: January 26, 2026 Revised: February 17, 2026 Accepted: April 22, 2026 Published online: June 20, 2026 Processing time: 139 Days and 2.8 Hours
Abstract
Ocular involvement in pediatric acute leukemia is an increasingly recognized, clinically relevant manifestation, but prevalence and patterns vary. It may arise from direct leukemic infiltration or secondary hematologic abnormalities. Recent observational studies, including Eastern India cohorts, underscore systematic ophthalmic evaluation at diagnosis. In a cohort of 47 children by Parija et al published in the World Journal of Experimental Medicine, ocular findings were present in 40.4% at presentation; most were asymptomatic and retinal hemorrhages predominated. Other series report similar patterns, with retinal hemorrhages common and prevalence roughly 40%-45%, while pooled meta-analytic estimates suggest an overall prevalence near 20%, differences likely reflect ethnicity, healthcare access, diagnostic protocols, study design, and sample size. Hematologic factors such as anemia and thrombocytopenia favor hemorrhagic lesions, whereas marked leukocytosis and high blast counts associate with infiltrative involvement of the retina, optic nerve, or orbit. Although some studies link ocular involvement to higher disease burden and worse outcomes, evidence is inconsistent because of methodological limitations and short follow-up. These findings support routine baseline ophthalmic screening, even in asymptomatic children, to detect vision-threatening lesions and clearly inform risk assessment. Larger prospective studies with standardized ocular and hematologic correlations are needed to define prognostic significance and optimize screening.
Core Tip: Ocular manifestations in pediatric acute leukemia are common but often underrecognized, despite reflecting underlying systemic disease burden. Retinal and optic nerve abnormalities may result from hematologic disturbances or direct leukemic infiltration and frequently occur without visual symptoms. Advances in retinal imaging have enhanced detection of overt and subclinical changes, supporting early ophthalmic assessment. This letter highlights the eye as a non-invasive indicator of disease severity and emphasizes the need for standardized screening and prospective research to improve multidisciplinary care.
