Retinal Manifestations of Hematological Disorders: Clinical and Hematological Correlates in a Tertiary Eye Care Centre

Abstract

Purpose: To evaluate the demographic profile, clinical characteristics, hematological abnormalities, and retinal manifestations of patients with hematological disorders, with particular emphasis on the association between individual hematological parameters and anemic retinopathy/Roth spots.

Materials and Methods: A hospital-based observational cross-sectional study was conducted among 14 patients with hematological abnormalities. Demographic and clinical details, ophthalmic findings, and hematological parameters including hemoglobin, PCV, RBC count, MCV, MCH, MCHC, TLC, and platelet count were recorded. The association between individual hematological parameters and anemic retinopathy was assessed using appropriate statistical tests.

Results: A total of 14 patients were included, with a mean age of 44.3 ± 17.5 years; 8 (57.1%) were females and 6 (42.9%) were males. Anemia was the most common hematological abnormality, present in 12 (85.7%) patients, followed by pancytopenia in 3 (21.4%), thrombocytopenia in 2 (14.3%), and polycythemia in 2 (14.3%). Retinal abnormalities were documented in 4 (28.6%) patients, including anemic retinopathy with Roth spots in 2 (14.3%). One patient with Roth spots also had a pre-macular hemorrhage. Patients with anemic retinopathy had significantly lower median hemoglobin (3.80 vs. 8.35 g/dL; P=0.030) and PCV (12.75% vs. 26.80%; P=0.036) compared with those without retinal involvement. Hemoglobin and PCV demonstrated significant inverse correlations with anemic retinopathy (r=−0.648, P=0.023 and r=−0.671, P=0.024, respectively). Other hematological indices, including RBC count, MCV, MCH, MCHC, TLC, and platelet count, showed no significant association.

Conclusion: Severe anemia, particularly markedly reduced hemoglobin and PCV, was significantly associated with anemic retinopathy and Roth spots. Thrombocytopenia may contribute to the severity of associated retinal hemorrhage, particularly in profound anemia. Larger studies are required to validate these findings.