Increased peripapillary capillaries in patients with acute leukemia by using optical coherence tomography angiography

•Patients with acute leukemia in early-stage showed fundus changes compared with healthy control.•Patients in the acute leukemia group had an increased radial peripapillary capillary vessel density and a thicker retinal nerve fiber layer.•Fundus changes showed a significant negative correlation with red blood cells, hemoglobin and hematocrit.•Optical coherence tomography angiography images can detect these early fundus changes noninvasively and effectively. To evaluate the radial peripapillary capillary vessel density (RPC-VD) and thickness of the retinal nerve fiber layer (RNFL) in acute leukemia (AL) and the associations of these characteristics with blood laboratory parameters. A cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from February 2019 to April 2022. Sixty eyes of 30 patients diagnosed with AL and sixty eyes of 30 matched healthy controls were included. Optical coherence tomography angiography (OCTA) in the 4.5-mm Angio Disc scan mode and the Ganglion cell complex scan mode were performed for all participants. Correlation analyses were used to examine the associations of RPC-VD and RNFL with blood laboratory parameters. Patients in the AL group had significantly increased RPC-VD in the whole-image (51.42±0.35 vs. 49.52±0.36) and peripapillary fields (53.90±0.43 vs. 51.17±0.50) compared with people in the control group (all P