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associates also noted the similar platelet counts
like Abu El-Asrar et al [21]. Robb and
colleagues, on the other hand, stated that there
was no correlation between the presence of
retinal hemorrhages and the hematologic
parameters in patients with acute leukemias
[11].
The correlation between the retinal findings
and the leucocyte count has been the subject
of much debate. Parallel to some studies, we
did not observe any significant difference in
leukocyte levels in patients having or those
not having retinal hemorrhage [19-21]. On the
other hand, Karesh et al. (1989) found that
their patients with retinopathy had a nonsignificantly
lower mean white blood cell
[22]. In contrast, Jackson and associates found
that high leukocyte levels were associated
with retinopathy in patients with leukemia but
stated that anemia and thrombocytopenia
were not associated with retinal hemorrhage
[23].
The limitation of the study was that the
number of ALL was less than AML. The
strength was that all eye examinations were
performed by the same clinician at the same
center.
In conclusion, our findings suggest that
anemia and thrombocytopenia are an
important factor in retinal hemorrhages in
acute leukemia and leukocyte count is not
associated with the retinal hemorrhages.
Considering that retinal hemorrhage is
detected incidentally during eye examination
in half of the patients, it is important to
evaluate the patients with active disease,
anemia and thrombocytopenia for retinal
hemorrhage.
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