THE EYE IN BONE-MARROW TRANSPLANTATION .6. RETINAL COMPLICATIONS

Objective: To evaluate the posterior segment ocular complications of p atients undergoing bone marrow transplantation (BMT). Design: Retrospe ctive analysis. Setting: Academic ophthalmology department at a tertia ry care hospital with a BMT unit. Patients: Patients undergoing BMT we re seen by an ophthalmologist for clinical care and enrolled in a long -term follow-up study, during which they were seen 6 and 12 months aft er the transplantation and annually thereafter. Results: Of 397 patien ts undergoing BMT, 51 (12.8%) developed posterior segment complication s. Fourteen patients (3.5%) developed hemorrhagic complications with e ither intraretinal and/or vitreous hemorrhages and 17 patients (4.3%) developed cotton-wool spots in the fundus of both eyes. Eleven patient s (2.8%) had bilateral optic disc edema, with eight cases attributed t o the toxic effects of cyclosporine and three to other causes. Two pat ients (0.5%) developed serous retinal detachments. Eight patients (2.0 %) developed infectious retinitis and/or endophthalmitis. Fungal infec tions with Candida or Aspergillus usually occurred within 120 days aft er BMT, while viral infections with herpes zoster or cytomegalovirus a nd parasitic infections with Toxoplasma occurred later. Intraocular ly mphoma occurred in one patient (0.2%). Conclusion: Severe, potentially vision-threatening, posterior segment complications following BMT occ ur due to a variety of causes.