Jm. Oriordan et al., RETINAL MICROVASCULAR CHANGES FOLLOWING BONE-MARROW TRANSPLANTATION -THE ROLE OF CYCLOSPORINE, Bone marrow transplantation, 13(1), 1994, pp. 101-104
Three patients complained of deteriorating vision 16, 20 and 29 weeks
following bone marrow transplantation (BMT) while receiving cyclospori
ne (CsA). Opthalmic examination revealed a marked microvascular retino
pathy with multiple cotton-wool spots, macular stars and retinal oedem
a. These appearances could not be accounted for by the mild to moderat
e hypertension in two cases, the third patient being normotensive. Two
of the patients had received total body irradiation (TBI) and cycloph
osphamide (CY) as conditioning therapy for BMT as well as previous cra
nial irradiation for acute lymphoblastic leukaemia; one case with chro
nic myeloid leukaemia was conditioned with busulphan and CY. Withdrawa
l of CsA in two patients and reduction of dose in the third led to com
plete resolution of retinopathy and restoration of visual function. Pr
evious reports have documented ischaemic fundus lesion in BMT recipien
ts treated with CsA and TBI. Our findings suggest that CsA in associat
ion with busulphan can produce a similar retinopathy.