Background  Hematologic diseases are prone to cause secondary ocular lesions, and the chief complaints and ophthalmic manifestations in patients with distinct hematologic diseases are various.

  Objective  To analyze the clinical features of ophthalmology in patients with different hematologic diseases, so as to provide reference for the diagnosis and treatment of secondary hematologic diseases.

  Methods  Clinical data about 88 cases with various hematological diseases who were recruited from the Department of Ophthalmology, the First Medical Center of Chinese PLA General Hospital from August 2018 to September 2021 were retrospectively analyzed. According to hematologic diseases, the number of cases in each group were counted. The age, gender, chief complaint of ophthalmology, best corrected visual acuity and fundus change of patients with different hematologic diseases were analyzed and compared.

  Results  Of the 88 cases, there were 59 males and 29 females with average age of 31.81 ± 13.31 years old, ranged from 4 to 64 years. Among them, there were 59 cases of acute leukemia (AL), 8 cases of aplastic anemia (AA), 5 cases of myelodysplastic syndrome (MDS) and 16 cases undergoing hematopoietic stem cell transplantation (HSCT). There was no significant difference in age and sex ratio among the four groups (P＞0.05). There were 26 patients with ophthalmic complaints, accounting for 29.55%, and the main complaints were visual loss. Fundus lesions were the main positive findings in ophthalmic examination, accounting for 54.54% (48 cases), and the prevalence in AL, AA, MDS and after HSCT were 44.07%, 87.5%, 100% and 62.5%, respectively (P＞0.05). Fundus lesions mostly involved in both eyes, accounted for 61.54%, 85.71%, 100% and 90% respectively, without significant difference between groups (P＞0.05). The fundus changes in patients with different hematologic diseases showed symmetrical characteristic changes in AL, AA and MDS, which were characterized by multi-morphology and multi-level hemorrhage, the fundus lesions in undergoing HSCT group tended to be more complex on the basis of the above changes (with typical cheese and ketchup retinopathy).

  Conclusion  The proportion of secondary ocular fundus diseases in patients with hematopathy is high, and ocular fundus diseases lead to decreased vision. The fundus changes in patients with hematologic diseases is characterized by binocular symmetry. The fundus changes in patients undergoing HSCT is more complex, and their visual acuity is worse than that of patients with other hematologic diseases, which should be paid more attention in clinical work.