Non‐invasive imaging of retinal blood flow in myeloproliferative neoplasms

• Published in: Acta ophthalmologica (Oxford, England) Vol. 95; no. 2; pp. 146 - 152
• Main Authors: Willerslev, Anne, Hansen, Mathias M., Klefter, Oliver Niels, Bjerrum, Ole Weis, Hasselbalch, Hans C., Clemmensen, Stine N., Larsen, Michael, Munch, Inger Christine
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2017
• Subjects: Adult; Aged; blood dyscrasia; Female; Follow-Up Studies; Humans; Male; Middle Aged; motion‐contrast imaging; Myeloproliferative Disorders - diagnosis; Myeloproliferative Disorders - physiopathology; non‐invasive retinal imaging; Ophthalmology; Prospective Studies; Regional Blood Flow - physiology; retinal blood flow; retinal oximetry; Retinal Vessels - diagnostic imaging; Retinal Vessels - physiopathology; spectral‐domain optical coherence tomography; Tomography, Optical Coherence - methods; Young Adult; spectral-domain optical coherence tomography; retinal oximetry; blood dyscrasia; non-invasive retinal imaging; retinal blood flow; motion-contrast imaging
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.13249

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‐naïve 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.