急性早幼粒細胞白血病合并視網膜內界膜下出血2例_Chinese Journal of Ocular Fundus Diseases

Authors：

徐愛珍 ¹ ,  李傳寶 ² , 周亞蘭 ²

1. ;
2. ;

Corresponding?author：

李傳寶, Email: 13853708298@126.com

Keywords：

急性早幼粒細胞白血病; 視網膜出血; 病例報告

DOI：

10.3760/cma.j.cn511434-20251020-00455

Video：

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Abstract Full text Figures/Tables Video References Cited by

1.	Alamri OS, Alsulami RE, Alqahtani BS, et al. Spontaneous resolution of foveal sub-internal limiting membrane hemorrhage with excellent visual and anatomical outcome in a patient with acute myeloid leukemia[J]. Middle East Afr J Ophthalmol, 2020, 27(1): 56-58. DOI: 10.4103/meajo.meajo_32_20.
2.	陳琪, 劉早霞. Valsalva視網膜內界膜下出血一例[J]. 新醫學, 2018, 49(9): 691-694. DOI: 10.3969/j.issn.0253-9802.2018.09.017.Chen Q, Liu ZX. Subarachnoid hemorrhage in Valsalva retinopathy: a case report[J]. New Medicine, 2018, 49(9): 691-694. DOI: 10.3969/j.issn.0253-9802.2018.09.017.
3.	鄒明, 張軍軍. 視網膜前出血和內界膜下出血[J]. 中華眼底病雜志, 2012, 28(1): 82-83. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.024.Zou M, Zhang JJ. Preretinal hemorrhage and subcapsular hemorrhage[J]. Chin J Ocul Fundus Dis, 2012, 28(1): 82-83. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.024.
4.	文峰, 張雄澤. 提高對視網膜出血的分類及臨床意義的認識[J]. 眼科, 2009, 18(4): 221-224.Wen F, Zhang XZ. Classification and clinical significance of retinal hemorrhage[J]. Ophthalmol CHN, 2009, 18(4): 221-224.
5.	Naymagon L, Mascarenhas J. Hemorrhage in acute promyelocytic leukemia: can it be predicted and prevented?[J/OL]. Leuk Res, 2020, 94: 106356[2020-05-11]. https://pubmed.ncbi.nlm.nih.gov/32445941/. DOI: 10.1016/j.leukres.2020.106356.
6.	中華醫學會血液學分會, 中國醫師協會血液科醫師分會. 中國急性早幼粒細胞白血病診療指南(2018年版)[J]. 中華血液學雜志, 2018, 39(3): 179-183. DOI: 10.3760/cma.j.issn.0253-2727.2018.03.002.Hematology Branch of Chinese Medical Association, Hematology Physicians Branch of Chinese Medical Doctor Association. Chinese guidelines for diagnosis and treatment of acute promyelocytic leukemia (2018)[J]. Chinese J Hematol, 2018, 39(3): 179-183. DOI: 10.3760/cma.j.issn.0253-2727.2018.03.002.
7.	Xiao M, Zhou P, Liu Y, et al. Predictive factors for differentiating thrombohemorrhagic disorders in high-risk acute promyelocytic leukemia[J]. Thromb Res, 2022, 210: 33-41. DOI: 10.1016/j.thromres.2021.12.020.
8.	Balubaid MM, Alqahtani AS. A case of acute promyelocytic leukemia with retinal hemorrhages beneath internal limiting membrane during clinical remission[J/OL]. Cureus, 2021, 13(2): e13387[2021-02-17]. https://pubmed.ncbi.nlm.nih.gov/33754110/. DOI: 10.7759/cureus.13387.
9.	Chien CC, Chen YY, Chen YH et al. Roth spots in acute promyelocytic leukemia[J]. QJM, 2022, 114(11): 826-827. DOI: 10.1093/qjmed/hcab238.
10.	Goel S, Das D, Saurabh K, et al. Bilateral sub-internal limiting membrane haemorrhage in acute myeloid leukaemia[J]. Clin Exp Optom, 2021, 104(1): 122-123. DOI: 10.1111/cxo.13106.
11.	Lyu S, Zhang M, Gao Y. Acute bilateral retina hemorrhages beneath internal limiting membrane: an unusual ophthalmological case report of acute leukemia during complete clinical remission[J/OL]. Medicine (Baltimore), 2018, 97(7): e0000[2018-02-01]. https://pubmed.ncbi.nlm.nih.gov/29443727/. DOI: 10.1097/MD.0000000000010000.
12.	肖哲, 張勝娟, 趙子琦, 等. Ultra Q: YAG激光治療黃斑部視網膜前出血17例并文獻復習[J]. 山東大學耳鼻喉眼學報, 2025, 39(1): 130-135. DOI: 10.6040/j.issn.1673-3770.0.2024.047.Xiao Z, Zhang SJ, Zhao ZQ, et al. Ultra Q: YAG laser treatment for macular retinal pre-retinal hemorrhage in 17 cases and literature review[J]. J Otolaryngol Ophthalmol Shandong Univ, 2025, 39(1): 130-135. DOI: 10.6040/j.issn.1673-3770.0.2024.047.
13.	張永鵬, 曹緒勝, 李繼鵬, 等. 黃斑部視網膜內界膜下出血行577 nm激光膜切開術的臨床研究[J]. 中華眼科, 2021, 11(3): 159-165. DOI: 10.3877/cma.j.issn.2095-2007.2021.03.006.Zhang YP, Cao XS, Li JP, et al. Effects of 577 nm laser membranotomy on macular sub-inner limiting membrane hemorrhage[J]. Chin J Ophthalmol, 2021, 11(3): 159-165. DOI: 10.3877/cma.j.issn.2095-2007.2021.03.006.
14.	Ikezoe T. Pathogenesis of disseminated intravascular coagulation in patients with acute promyelocytic leukemia, and its treatment using recombinant human soluble thrombomodulin[J]. Int J Hematol, 2014, 100(1): 27-37. DOI: 10.1007/s12185-013-1463-0.
15.	Hisada Y. Dysregulated hemostasis in acute promyelocytic leukemia[J]. Int J Hematol, 2024, 119(5): 526-531. DOI: 10.1007/s12185-024-03708-0.
16.	Kuchenbauer F, Buske C. Revisiting thrombocytopenia in acute promyelocytic leukemia[J]. Leukemia, 2018, 32(6): 1477-1478. DOI: 10.1038/s41375-018-0105-1.
17.	Hisada Y, Archibald S J, Bansal K, et al. Biomarkers of bleeding and venous thromboembolism in patients with acute leukemia[J]. J Thromb Haemost, 2024, 22(7): 1984-1996. DOI: 10.1016/j.jtha.2024.03.020.
18.	陳珍珠, 劉濤, 郭賀賀, 等. 急性早幼粒細胞白血病治療過程中凝血功能變化及影響因素分析[J]. 中國實驗血液學雜志, 2025, 33(1): 45-53. DOI: 10.19746/j.cnki.issn1009-2137.2025.01.007.Chen ZZ, Liu T, Guo HH, et al. Analysis of coagulation changes and influencing factors during treatment of acute promyelocytic leukemia[J]. Journal of Experimental Hematology, 2025, 33(1): 45-53. DOI: 10.19746/j.cnki.issn1009-2137.2025.01.007.
19.	王霞, 劉訓濤, 周素濤, 等. 急性白血病患者凝血指標和VEGF的檢測及臨床意義[J]. 醫學綜述, 2022, 28(1): 184-189. DOI: 10.3969/j.issn.1006-2084.2022.01.033.Wang X, Liu XT, Zhou ST et al. Detection and clinical significance of coagulation index and VEGF in patients with acute leukemia[J]. Medical Recapitulate, 2022, 28(1): 184-189. DOI: 10.3969/j.issn.1006-2084.2022.01.033.
20.	趙明威. 深入認識DR與CRVO發病機制的特點及治療策略[J]. 中華眼科雜志, 2025, 61(3): 168-172. DOI: 10.3760/cma.j.cn112142-20241210-00575.Zhao MW. Deeply understanding the pathological characteristics of diabetic retinopathy and central retinal vein occlusion and the similarities and differences in therapeutic strategies[J]. Chin J Ophthalmol, 2025, 61(3): 168-172. DOI: 10.3760/cma.j.cn112142-20241210-00575.
21.	Reddy SC, Jackson N. Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters[J]. Acta Ophthalmol Scand, 2004, 82(1): 81-85. DOI: 10.1046/j.1600-0420.2003.00197.x.
22.	Sabljic N, Pantic N, Virijevic M, et al. Risk factors for venous thromboembolism in acute promyelocytic leukemia[J/OL]. Cancers (Basel), 2024, 16(24): 4209[2024-12-17]. https://pubmed.ncbi.nlm.nih.gov/39766107/. DOI: 10.3390/cancers16244209.
23.	Sabljic N, Thachil J, Pantic N, et al. Hemorrhage in acute promyelocytic leukemia-fibrinolysis in focus[J/OL]. Res Pract Thromb Haemost, 2024, 8(5): 102499[2024-07-02]. https://pubmed.ncbi.nlm.nih.gov/39130779/. DOI: 10.1016/j.rpth.2024.102499.
24.	Tallman MS, Abutalib SA, Altman JK. The double hazard of thrombophilia and bleeding in acute promyelocytic leukemia[J]. Semin Thromb Hemost, 2007, 33(4): 330-338. DOI: 10.1055/s-2007-976168.
25.	Ková?ová M, Kousal B, Meli?ka M, et al. Treatment options for premacular and sub-internal limiting membrane hemorrhage[J]. Cesk Slov Oftalmol, 2021, 77(6): 289-294. DOI: 10.31348/2021/34.
26.	Liu T, Johnson TV, Barnett BP, et al. Evolution of leukemic retinal hemorrhages documented by spectral-domain OCT and color fundus photography[J]. Ophthalmol Retina, 2018, 2(5): 494-501. DOI: 10.1016/j.oret.2017.08.014.
27.	Hussain RN, Stappler T, Hiscott P, et al. Histopathological changes and clinical outcomes following intervention for sub-internal limiting membrane haemorrhage[J]. Ophthalmologica, 2020, 243(3): 217-223. DOI: 10.1159/000502442.

1. Alamri OS, Alsulami RE, Alqahtani BS, et al. Spontaneous resolution of foveal sub-internal limiting membrane hemorrhage with excellent visual and anatomical outcome in a patient with acute myeloid leukemia[J]. Middle East Afr J Ophthalmol, 2020, 27(1): 56-58. DOI: 10.4103/meajo.meajo_32_20.
2. 陳琪, 劉早霞. Valsalva視網膜內界膜下出血一例[J]. 新醫學, 2018, 49(9): 691-694. DOI: 10.3969/j.issn.0253-9802.2018.09.017.Chen Q, Liu ZX. Subarachnoid hemorrhage in Valsalva retinopathy: a case report[J]. New Medicine, 2018, 49(9): 691-694. DOI: 10.3969/j.issn.0253-9802.2018.09.017.
3. 鄒明, 張軍軍. 視網膜前出血和內界膜下出血[J]. 中華眼底病雜志, 2012, 28(1): 82-83. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.024.Zou M, Zhang JJ. Preretinal hemorrhage and subcapsular hemorrhage[J]. Chin J Ocul Fundus Dis, 2012, 28(1): 82-83. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.024.
4. 文峰, 張雄澤. 提高對視網膜出血的分類及臨床意義的認識[J]. 眼科, 2009, 18(4): 221-224.Wen F, Zhang XZ. Classification and clinical significance of retinal hemorrhage[J]. Ophthalmol CHN, 2009, 18(4): 221-224.
5. Naymagon L, Mascarenhas J. Hemorrhage in acute promyelocytic leukemia: can it be predicted and prevented?[J/OL]. Leuk Res, 2020, 94: 106356[2020-05-11]. https://pubmed.ncbi.nlm.nih.gov/32445941/. DOI: 10.1016/j.leukres.2020.106356.
6. 中華醫學會血液學分會, 中國醫師協會血液科醫師分會. 中國急性早幼粒細胞白血病診療指南(2018年版)[J]. 中華血液學雜志, 2018, 39(3): 179-183. DOI: 10.3760/cma.j.issn.0253-2727.2018.03.002.Hematology Branch of Chinese Medical Association, Hematology Physicians Branch of Chinese Medical Doctor Association. Chinese guidelines for diagnosis and treatment of acute promyelocytic leukemia (2018)[J]. Chinese J Hematol, 2018, 39(3): 179-183. DOI: 10.3760/cma.j.issn.0253-2727.2018.03.002.
7. Xiao M, Zhou P, Liu Y, et al. Predictive factors for differentiating thrombohemorrhagic disorders in high-risk acute promyelocytic leukemia[J]. Thromb Res, 2022, 210: 33-41. DOI: 10.1016/j.thromres.2021.12.020.
8. Balubaid MM, Alqahtani AS. A case of acute promyelocytic leukemia with retinal hemorrhages beneath internal limiting membrane during clinical remission[J/OL]. Cureus, 2021, 13(2): e13387[2021-02-17]. https://pubmed.ncbi.nlm.nih.gov/33754110/. DOI: 10.7759/cureus.13387.
9. Chien CC, Chen YY, Chen YH et al. Roth spots in acute promyelocytic leukemia[J]. QJM, 2022, 114(11): 826-827. DOI: 10.1093/qjmed/hcab238.
10. Goel S, Das D, Saurabh K, et al. Bilateral sub-internal limiting membrane haemorrhage in acute myeloid leukaemia[J]. Clin Exp Optom, 2021, 104(1): 122-123. DOI: 10.1111/cxo.13106.
11. Lyu S, Zhang M, Gao Y. Acute bilateral retina hemorrhages beneath internal limiting membrane: an unusual ophthalmological case report of acute leukemia during complete clinical remission[J/OL]. Medicine (Baltimore), 2018, 97(7): e0000[2018-02-01]. https://pubmed.ncbi.nlm.nih.gov/29443727/. DOI: 10.1097/MD.0000000000010000.
12. 肖哲, 張勝娟, 趙子琦, 等. Ultra Q: YAG激光治療黃斑部視網膜前出血17例并文獻復習[J]. 山東大學耳鼻喉眼學報, 2025, 39(1): 130-135. DOI: 10.6040/j.issn.1673-3770.0.2024.047.Xiao Z, Zhang SJ, Zhao ZQ, et al. Ultra Q: YAG laser treatment for macular retinal pre-retinal hemorrhage in 17 cases and literature review[J]. J Otolaryngol Ophthalmol Shandong Univ, 2025, 39(1): 130-135. DOI: 10.6040/j.issn.1673-3770.0.2024.047.
13. 張永鵬, 曹緒勝, 李繼鵬, 等. 黃斑部視網膜內界膜下出血行577 nm激光膜切開術的臨床研究[J]. 中華眼科, 2021, 11(3): 159-165. DOI: 10.3877/cma.j.issn.2095-2007.2021.03.006.Zhang YP, Cao XS, Li JP, et al. Effects of 577 nm laser membranotomy on macular sub-inner limiting membrane hemorrhage[J]. Chin J Ophthalmol, 2021, 11(3): 159-165. DOI: 10.3877/cma.j.issn.2095-2007.2021.03.006.
14. Ikezoe T. Pathogenesis of disseminated intravascular coagulation in patients with acute promyelocytic leukemia, and its treatment using recombinant human soluble thrombomodulin[J]. Int J Hematol, 2014, 100(1): 27-37. DOI: 10.1007/s12185-013-1463-0.
15. Hisada Y. Dysregulated hemostasis in acute promyelocytic leukemia[J]. Int J Hematol, 2024, 119(5): 526-531. DOI: 10.1007/s12185-024-03708-0.
16. Kuchenbauer F, Buske C. Revisiting thrombocytopenia in acute promyelocytic leukemia[J]. Leukemia, 2018, 32(6): 1477-1478. DOI: 10.1038/s41375-018-0105-1.
17. Hisada Y, Archibald S J, Bansal K, et al. Biomarkers of bleeding and venous thromboembolism in patients with acute leukemia[J]. J Thromb Haemost, 2024, 22(7): 1984-1996. DOI: 10.1016/j.jtha.2024.03.020.
18. 陳珍珠, 劉濤, 郭賀賀, 等. 急性早幼粒細胞白血病治療過程中凝血功能變化及影響因素分析[J]. 中國實驗血液學雜志, 2025, 33(1): 45-53. DOI: 10.19746/j.cnki.issn1009-2137.2025.01.007.Chen ZZ, Liu T, Guo HH, et al. Analysis of coagulation changes and influencing factors during treatment of acute promyelocytic leukemia[J]. Journal of Experimental Hematology, 2025, 33(1): 45-53. DOI: 10.19746/j.cnki.issn1009-2137.2025.01.007.
19. 王霞, 劉訓濤, 周素濤, 等. 急性白血病患者凝血指標和VEGF的檢測及臨床意義[J]. 醫學綜述, 2022, 28(1): 184-189. DOI: 10.3969/j.issn.1006-2084.2022.01.033.Wang X, Liu XT, Zhou ST et al. Detection and clinical significance of coagulation index and VEGF in patients with acute leukemia[J]. Medical Recapitulate, 2022, 28(1): 184-189. DOI: 10.3969/j.issn.1006-2084.2022.01.033.
20. 趙明威. 深入認識DR與CRVO發病機制的特點及治療策略[J]. 中華眼科雜志, 2025, 61(3): 168-172. DOI: 10.3760/cma.j.cn112142-20241210-00575.Zhao MW. Deeply understanding the pathological characteristics of diabetic retinopathy and central retinal vein occlusion and the similarities and differences in therapeutic strategies[J]. Chin J Ophthalmol, 2025, 61(3): 168-172. DOI: 10.3760/cma.j.cn112142-20241210-00575.
21. Reddy SC, Jackson N. Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters[J]. Acta Ophthalmol Scand, 2004, 82(1): 81-85. DOI: 10.1046/j.1600-0420.2003.00197.x.
22. Sabljic N, Pantic N, Virijevic M, et al. Risk factors for venous thromboembolism in acute promyelocytic leukemia[J/OL]. Cancers (Basel), 2024, 16(24): 4209[2024-12-17]. https://pubmed.ncbi.nlm.nih.gov/39766107/. DOI: 10.3390/cancers16244209.
23. Sabljic N, Thachil J, Pantic N, et al. Hemorrhage in acute promyelocytic leukemia-fibrinolysis in focus[J/OL]. Res Pract Thromb Haemost, 2024, 8(5): 102499[2024-07-02]. https://pubmed.ncbi.nlm.nih.gov/39130779/. DOI: 10.1016/j.rpth.2024.102499.
24. Tallman MS, Abutalib SA, Altman JK. The double hazard of thrombophilia and bleeding in acute promyelocytic leukemia[J]. Semin Thromb Hemost, 2007, 33(4): 330-338. DOI: 10.1055/s-2007-976168.
25. Ková?ová M, Kousal B, Meli?ka M, et al. Treatment options for premacular and sub-internal limiting membrane hemorrhage[J]. Cesk Slov Oftalmol, 2021, 77(6): 289-294. DOI: 10.31348/2021/34.
26. Liu T, Johnson TV, Barnett BP, et al. Evolution of leukemic retinal hemorrhages documented by spectral-domain OCT and color fundus photography[J]. Ophthalmol Retina, 2018, 2(5): 494-501. DOI: 10.1016/j.oret.2017.08.014.
27. Hussain RN, Stappler T, Hiscott P, et al. Histopathological changes and clinical outcomes following intervention for sub-internal limiting membrane haemorrhage[J]. Ophthalmologica, 2020, 243(3): 217-223. DOI: 10.1159/000502442.

Chinese Journal of Ocular Fundus Diseases

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