The eye in bone marrow transplantation. VI. Retinal complications

N. M. Coskuncan, D. A. Jabs, J. P. Dunn, J. A. Haller, W. R. Green, G. B. Vogelsang and G. W. Santos
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

OBJECTIVE: To evaluate the posterior segment ocular complications of patients undergoing bone marrow transplantation (BMT). DESIGN: Retrospective analysis. SETTING: Academic ophthalmology department at a tertiary care hospital with a BMT unit. PATIENTS: Patients undergoing BMT were seen by an ophthalmologist for clinical care and enrolled in a long-term follow-up study, during which they were seen 6 and 12 months after the transplantation and annually thereafter. RESULTS: Of 397 patients undergoing BMT, 51 (12.8%) developed posterior segment complications. Fourteen patients (3.5%) developed hemorrhagic complications with either intraretinal and/or vitreous hemorrhages and 17 patients (4.3%) developed cotton-wool spots in the fundus of both eyes. Eleven patients (2.8%) had bilateral optic disc edema, with eight cases attributed to the toxic effects of cyclosporine and three to other causes. Two patients (0.5%) developed serious retinal detachments. Eight patients (2.0%) developed infectious retinitis and/or endophthalmitis. Fungal infections with Candida or Aspergillus usually occurred within 120 days after BMT, while viral infections with herpes zoster or cytomegalovirus and parasitic infections with Toxoplasma occurred later. Intraocular lymphoma occurred in one patient (0.2%). CONCLUSION: Severe, potentially vision-threatening, posterior segment complications following BMT occur due to a variety of causes.

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