| Objective:Evaluation of Acute myelocytic leukemia with Optical coherence tomography(OCTA)Hematopoietic stem cell transplantion(HSCT)patients underwent preoperative and postoperative hematopoietic stem cell transplantion(HSCT),general ocular conditions and vascular density changes in macular region,and correlation analysis was conducted between hematologic indexes,disease course,and chemotherapy course before transplantation.Methods:A total of 19 cases(38 eyes)of AML patients intending to undergo HSCT were selected from Zhejiang Provincial People’s Hospital for ophthalmic consultation from February 21 to December 20,2022.12.The 28 eyes with no clinically visible retinopathy in the eyes were defined as the group without fundus lesions,and the 10 eyes with retinopathy such as obvious bleeding were selected as the fundus lesions group.The Best corrected visual acuity(BCVA)and the full-layer retinal thickness of the macular fovea before and 3 months after HSCT were observed and compared between the fundus lesion group and the non-fundus lesion group thickness,CMT),Retinal nerve fiber layer(RNFL),Foveal avascular zone(Foveal avascular zone,Superficial capillary plexus(SCP),superficial capillary plexus(SCP),Deep capillary plexus,DCP)Vascular density(Vascular density,VD)6 * 6 mm scanning scope of retinal blood vessel image at every level,at the same time,the examination of the related parameters of hematology,including Hemoglobin(HB)Hemoglobin,count,White blood cells(White blood cell,(WBC)count,Red blood cell(RBC)count,Platelets(PLT)count and proportion of Lactic dehydrogenase(Lactic dehydrogenase),LDH),and the correlation between OCTA parameters in the fundus disease group and the group without fundus disease and hematological indicators,course of disease,chemotherapy course was studied.Results: 1.Before hematopoietic stem cell transplantation: compared with the group without fundus lesions,the proportion of naive cells and the course of chemotherapy in the fundus lesions group were significantly increased(P < 0.05);2.Before hematopoietic stem cell transplantation: the count of HB,RBC,RBC and PLT in the fundus lesion group was significantly decreased compared with that in the non-fundus lesion group(P < 0.05).3.Before hematopoietic stem cell transplantation: compared with the non-fundus disease group,the vascular density of SCP,DCP and BCVA in the fundus disease group were significantly decreased(P < 0.05).4.After 3 months hematopoietic stem cell transplantation: compared with the non-fundus lesion group,the vascular density of SCP,DCP,FAZ area,BCVA,CMT and RNFL in the fundus lesion group had no statistical significance(P > 0.05).5.After 3 months hematopoietic stem cell transplantation,compared with before hematopoietic stem cell transplantation: the blood vessel density of SCP and DCP in macular fovea in the fundus lesion group was significantly increased,and the area of FAZ was significantly decreased(P < 0.05).The vascular density of SCP and DCP in the fovea of macular area was increased significantly,while the area of FAZ was decreased significantly(P < 0.05).6.After 3 months hematopoietic stem cell transplantation,compared with before hematopoietic stem cell transplantation,RNFL thickness and CMT in the fundus lesion group and the non-fundus lesion group were not statistically significant(p > 0.05).Conclusion:1.Fundus lesions in AML patients were associated with increased proportion of naive cells,decreased red blood cell count,platelet count,white blood cell count,hemoglobin content,increased chemotherapy course and other factors;2.It was found by OCTA that the fovea of macular fundus in AML patients with fundus lesions had begun to show microvascular injury: the vascular density of SCP and DCP decreased significantly,while BCVA decreased significantly.3.For AML patients,active treatment of the primary disease is conducive to the improvement of fundus blood supply. |
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