Ocular manifestations of patients receiving heart transplants: a single-center experience of 311 consecutive cases.
OBJECTIVE
The purpose of this study was to investigate ocular manifestations of patients undergoing heart transplantations.


METHODS
We retrospectively reviewed the clinical data of 311 patients who underwent orthotropic heart transplantations from January 1989 to December 2007, including the demographic data, general conditions, medications, as well as the basic ophthalmic examinations, ophthalmic diagnosis, and management.


RESULTS
Of the 311 heart transplant recipients, common diagnoses included cataract (96 cases; 30.87%), dry eye syndrome (24 cases; 7.72%), allergic conjunctivitis (78 cases; 25.08%), and glaucoma (19 cases; 6.11%). The patients after heart transplantation had much lower incidences of severe opportunistic infections than patients undergoing the same procedure one decade ago. However, autoimmune-related endocrinopathy such as diabetes and Graves' disease became more prevalent. Diabetes-related complications were unexpectedly frequent, including nonproliferative diabetic retinopathy (6 cases; 1.93%), proliferative diabetic retinopathy (6 cases; 1.93%), retinal vein occlusion (6 cases; 1.93%), and neovascular glaucoma (4 cases; 1.29%). The occurrence of cataract formation and steroid glaucoma was often due to post-transplantation steroid use.


CONCLUSIONS
Ophthalmologists and cardiac surgeons should collaborate and perform regular ophthalmic examinations, especially for those who have new-onset diabetes and difficulty tapering off steroids.
Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
C-C
CC
Su
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
J-W
JW
Chen
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
N-K
NK
Chou
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Y-S
YS
Chen
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
S-C
SC
Huang
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
N-H
NH
Chi
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wangp@ntu.edu.tw.
S-S
SS
Wang
D000328:Adult; D005128:Eye Diseases / Q000145:classification / Q000209:etiology*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies