Non-invasive imaging of retinal blood flow in myeloproliferative neoplasms

作者：Willerslev Anne^*; Hansen Mathias M; Klefter Oliver Niels; Bjerrum Ole Weis; Hasselbalch Hans C; Clemmensen Stine N; Larsen Michael; Munch Inger Christine

来源：Acta Ophthalmologica, 2017, 95(2): 146-152.

DOI：10.1111/aos.13249

• blood dyscrasia
• motion-contrast imaging
• non-invasive retinal imaging
• retinal blood flow
• retinal oximetry
• spectral-domain optical coherence tomography

Purpose: To study the circulation in the retinal vessels in patients with blood dyscrasia due to myeloproliferative neoplasms using non-invasive retinal imaging.
Methods: Prospective consecutive case series of seven treatment-naive patients with chronic myeloid leukaemia (n = 2), polycythemia vera (n = 4), essential thrombocytosis (n = 1) examined before and after cytoreductive treatment. We investigated retinal circulation with motion-contrast imaging, retinal oximetry and spectral-domain optical coherence tomography.
Results: Retinal venous blood velocity increased by 8.14% (CI95 3.67% to 12.6%, p = 0.004) and retinal arterial oxygen saturation increased by 7.23% (CI95 2.9% to 11.6%, p = 0.010) at follow-up (mean 12 weeks, range 5-14 weeks) where complete haematological remission had been achieved by cytoreductive treatment. Abnormal optical coherence tomography reflectivity patterns were present at baseline in patients with chronic myeloid leukaemia and were replaced by normal patterns at follow-up. Retinopathy, in the form of cotton-wool spots and retinal haemorrhages, was found at presentation in the two patients with chronic myeloid leukaemia and in one patient with polycythemia vera. The retinopathy had resolved at follow-up in all patients.
Conclusion: With non-invasive retinal imaging, we were able to demonstrate increased retinal venous blood velocity, increased retinal arterial blood oxygenation and normalization of intravascular reflectivity patterns after successful treatment of myeloproliferative neoplasms. Larger prospective studies are needed to assess the prognostic value of these non-invasive imaging methods in predicting circulatory complications in myeloproliferative neoplasms.

• 出版日期2017-3