ISCHEMIC RETINOPATHY OCCURRING IN PATIENTS RECEIVING BONE-MARROW ALLOGRAFTS AND CAMPATH-1G - A CLINICOPATHOLOGICAL STUDY

Aims/Background-Ischaemic retinopathy is a well characterised complica tion of bone marrow transplantation (BMT). Although the aetiology is u nclear, it is most probably multifactorial, and may be related to trea tment such as radiation and cyclosporin A. The clinical findings are r eported of two patients who developed such a retinopathy and the ocula r histology from one of these cases is presented. Methods-Two patients underwent BMT for acute lymphoblastic leukaemia, receiving campath-1G for prophylaxis against graft versus host disease, and showed fundal changes compatible with BMT retinopathy. The eyes from one patient wer e retrieved at post mortem and examined by both light and electron mic roscopy. Results-The visual symptoms and fundal signs resolved spontan eously with no specific treatment in one patient. Light and electron m icroscopic examination of the eyes of the other patient was compatible with an ischaemic aetiology and showed evidence of retinal capillary endothelial loss. Conclusions-(i) Histopathology in one case of BMT re tinopathy demonstrates a retinal endotheliopathy similar to that descr ibed in radiation retinopathy. (ii) BMT retinopathy may occur in the a bsence of cyclosporin A treatment. (iii) The retinopathy can recover s pontaneously with no specific treatment.