Ocular findings after allogeneic hematopoietic stem cell transplantation.
OBJECTIVE
To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).


METHODS
Retrospective, noncomparative, observational clinical study.


METHODS
The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.


METHODS
Allogeneic HSCT.


METHODS
Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded.


RESULTS
Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%).


CONCLUSIONS
Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Tabbara
Khalid F
KF
The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia. k.tabbara@nesma.net.sa
Al-Ghamdi
Ahmad
A
Al-Mohareb
Fahad
F
Ayas
Mouhab
M
Chaudhri
Naeem
N
Al-Sharif
Fahad
F
Al-Zahrani
Hazzaa
H
Mohammed
Said Y
SY
Nassar
Amr
A
Aljurf
Mahmoud
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005128:Eye Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009887:Ophthalmoscopy; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D014792:Visual Acuity / Q000502:physiology
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008727:Methotrexate