PIGMENTARY IRREGULARITIES AND OPTIC DISC EDEMA AFTER HEART-TRANSPLANTATION

Objectives: To determine the prevalence of chorioretinal lesions and o ptic disc edema after heart transplantation and to study potential ass ociations. Design and Patients: One hundred one patients who had under gone heart transplantation at one institution and 19 patients prior to heart transplantation underwent ophthalmological examination, includi ng fundus photography. The prevalence of fundus lesions was then compa red between the two groups. Main Outcome Measure: With a standardized protocol, the presence of optic disc edema, chorioretinal hyperpigment ation and depigmentation, retinal hemorrhages, cotton-wool lesions, an d arteriovenous nicking was graded on color transparencies. Results: T he prevalence of optic disc edema and hypopigmentations was significan tly higher among the transplant recipients than among the patients pri or to heart transplantation (31% vs 5%, P=.01, and 55% vs 11%, P<.001, respectively). Hyperpigmentation was only present in patients after t ransplantation (15% vs 0%, P=.06). Heart transplant recipients showed an increased risk of hyperpigmentations after 2.5 years. Acute rejecti on episodes were not associated with posterior pole lesions. Conclusio n: Common posterior pole lesions after heart transplantation are optic disc edema and pigmentary changes. Although visual acuity does not se em severely impaired, further longitudinal study is necessary to evalu ate the long-term significance of these lesions.