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VI. Retinal Complications

Nezih M. Coskuncan, MD; Douglas A. Jabs, MD; J. P. Dunn, MD; Julia A. Haller, MD; W. Richard Green, MD; Georgia B. Vogelsang, MD; George W. Santos, MD

Arch Ophthalmol. 1994;112(3):372-379.

Abstract
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 serous 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.

Author Affiliations
From The Wilmer Ophthalmological Institute, the Department of Ophthalmology (Drs Coskuncan, Jabs, Dunn, Haller, and Green), and The Johns Hopkins Oncology Center (Drs Vogelsang and Santos), The Johns Hopkins University School of Medicine, Baltimore, Md.

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