POSTERIOR EYE SEGMENT COMPLICATIONS RELATED TO ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION

Retina. 2017 Jan;37(1):135-143. doi: 10.1097/IAE.0000000000001122.

Abstract

Purpose: To identify complications in the posterior eye segment in patients who have undergone allogeneic hematopoietic stem cell transplantation (HSCT).

Methods: This retrospective cohort study enrolled 747 patients with hematologic disease who had undergone allogeneic HSCT at Seoul St. Mary's Hospital from January 2009 to December 2012. The posterior eye segment complications were evaluated by reviewing information in medical records at the Department of Hematology and Ophthalmology, including the types, onset times, locations, and resolution times of the complications according to the treatment periods for HSCT; in addition, a subgroup analysis was performed.

Results: Among the 635 included patients, 48 (7.6%) experienced complications related to HSCT in the posterior eye segment. Twenty patients were diagnosed with retinal hemorrhage, 16 with cytomegalovirus (CMV) retinitis, and 5 with uveitis. Six patients (37.5%) with retinal hemorrhage had a lesion in Zone 1 and took more time to recover from this complication. Retinal tear (1/16, 6.3%) and rhegmatogenous retinal detachment (2/16, 12.5%) were observed in the patients with CMV retinitis. Among the 20 patients with retinal hemorrhage, 18 (90.0%) had thrombocytopenia, 14 (70.0%) had pancytopenia, and 7 (35.0%) had profound cytopenia. Cytomegalovirus viremia was detected in 16 (72.7%) of the 22 patients with inflammation-associated complications.

Conclusion: Understanding of each patient's general condition, which is affected by the specific procedures used for HSCT, is important for the diagnosis and management of transplantation-related complications in the posterior eye segment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cytomegalovirus Retinitis / etiology
  • Eye Diseases / etiology*
  • Eye Diseases / pathology
  • Female
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Optic Nerve Diseases / etiology
  • Posterior Eye Segment / pathology*
  • Postoperative Complications*
  • Retinal Diseases / etiology
  • Retrospective Studies
  • Uveitis / etiology
  • Young Adult