Retinal microaneurysms in leukaemia.

THE purpose of this report is to describe the presence of microaneurysms in the retinae of patients who died with leukaemia. Although this type of lesion is most frequently observed in association with diabetes mellitis, it has, during recent years, been described clinically and/or histologically in association with a diverse variety of apparently unrelated entities. In a few instances the lesion appears in relation to conditions localized within the eye. Microaneurysms are frequently observed after thrombosis of the central retinal vein or one of its branches (Loewenstein and Garrow, 1945; Ashton, 1951), and they have also been described in association with retinoblastoma (Ashton, 1951; Wolter, 1961), Eales's disease (Wise, 1957), Coats's disease (Lorentzen, 1959), loa-loa (Toussaint and Danis, 1965), and chorioretinitis (Ashton, 1951; Wise, 1957). They have also been observed in association with a variety of systemic diseases: hypertension (Friedenwald, 1950), the haemoglobinopathies (Edington and Sarkies, 1952; Goodman, von Sallmann, and Holland, 1957), the dysproteinaemias (Ashton, Kok, and Foulds, 1963; Carr and Henkind, 1963), cyanotic disease states (Oliviera, 1966), primary and secondary polycythaemia (Ashton and others, 1963), severe anaemias (Friedenwald, 1950; Becker, Allen, Winter, Maengwyn-Davies, and Friedenwald, 1954), pulseless disease (Dowling and Smith, 1960), and even as a component of the process of ageing (Kuwabara and Cogan, 1960). Two recent clinico-pathological reports by Allen and Straatsma (1961) and by Mahneke and Videbaeh (1964) have stressed the high incidence of retinal lesions in patients with leukaemia. Commonly observed are dilated tortuous veins, leukaemic infiltrates, haemorrhages, and exudates. Papilloedema and retinal oedema are less frequently seen. Neither of these recent reports cited retinal microaneurysms as a feature of leukaemic retinopathy. Similarly, in a review of the recent literature concerning retinal vascular pathology, we were unable to find reports of these lesions in association with leukaemia.