Clinical Manifestations and Ophthalmic Outcomes of Leukemic Retinopathy and Optic Neuropathy in Patients With Acute Leukemia
Bibliographic record
Abstract
Purpose: To investigate the clinical manifestations and visual outcomes of leukemic retinopathy and optic neuropathy (LRON) in patients with acute leukemia. Methods: We recruited 276 patients with acute leukemia, 55 of whom had LRON. The ophthalmic measurements, treatment courses, laboratory data, and molecular profiling were retrospectively collected. Results: Patients with LRON were classified as type 1, type 2a, type 2b, and type 3. All patients with type 3 LRON had acute lymphoblastic leukemia (ALL), while the other types of LRON mainly occurred in patients with acute myeloid leukemia (AML). Patients with type 2b and type 3 LRON had worse initial best-corrected visual acuity (BCVA); none of the patients with type 3 LRON had recovery of BCVA during follow-up. The patients with AML with LRON were more likely to undergo hematopoietic stem cell transplantation (P < 0.001); their leukemic blasts more frequently expressed CD7 (P = 0.004) and CD38 (P = 0.048) and harbored DNMT3A (P = 0.017) and IDH1 (P = 0.041) mutations. Notably, the co-occurrence of DNMT3A, IDH1, and TET2 mutations was associated with a particularly high risk of LRON (odds ratio = 16.41). The patients with ALL with type 3 LRON had higher rates of central nervous system involvement (P = 0.041) and relapsed leukemia (P = 0.007). Nevertheless, the presence of LRON did not significantly affect survival in acute leukemia. Conclusions: We characterized distinct clinical, genetic features and visual outcomes across LRON subtypes. Our study highlights the importance of prompt ophthalmic consultation and patient education regarding visual symptoms in acute leukemia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.009 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".