Bone marrow transplantation and cataract development.
OBJECTIVE
To evaluate risk factors for the development of posterior subcapsular cataract following bone marrow transplantation (BMT) and the results of patients undergoing cataract extraction.


METHODS
Retrospective case-control study.


METHODS
Tertiary referral center.


METHODS
Three hundred sixty-six patients (59% male, 41% female) undergoing BMT at one institution who survived for at least 1 month and underwent full ophthalmologic examination. Risk factors were then compared between patients who developed posterior subcapsular cataract and those who did not.


METHODS
Cataract surgery in six eyes of four patients.


METHODS
Formation of posterior subcapsular cataract. Data were obtained on all patients for type of BMT, pretransplantation regimen, underlying malignancy, demographic background, complications of BMT, and medications.


RESULTS
Forty (10.9%) of 366 patients developed posterior subcapsular cataract. By univariate analysis, cataract formation was associated with total body irradiation, chronic graft-vs-host disease, the use of allogeneic bone marrow, and the total dose and duration of corticosteroid therapy. Multivariate analysis revealed that the total dose and duration of corticosteroid therapy were the most important risk factors, while total body irradiation was not a statistically significant risk factor. Cataract surgery was performed in six eyes of four patients, all of whom developed visual acuities of 20/40 or better.


CONCLUSIONS
Posterior subcapsular cataract following BMT is uncommon and rarely requires surgery. Total dose and duration of corticosteroid therapy are the most important risk factors for development of cataract, but total body irradiation is not a statistically significant risk factor.
Dunn
J P
JP
Department of Ophthalmology, Johns Hopkins University, Baltimore, Md.
Jabs
D A
DA
Wingard
J
J
Enger
C
C
Vogelsang
G
G
Santos
G
G
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016022:Case-Control Studies; D002386:Cataract / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014916:Whole-Body Irradiation / Q000009:adverse effects
D005938:Glucocorticoids