Ocular complications of pediatric bone marrow transplantation

Objective: To investigate the ocular complications in pediatric bone marrow transplantation (BMT) patients, Design: Cross-sectional study. Participants: A total of 29 pediatric BMT patients were studied. Testing: Comprehensive ophthalmic check-up, including best-corrected visual acuity, intraocular pressure (IOP), Schirmer's test, tear breakup time, an d slit-lamp and fundus examinations, was performed. Main Outcome Measures: Tear film instability and its related complications, IOP, cataract, and fundus lesions were measured. Results: The mean age of patients was 9.1 years (range, 1.5-15 years). The mean post-BMT duration was 20.2 months (range, 3-54 months), Fifteen patien ts (51.7%) had tear abnormalities. Subconjunctival fibrosis was detected in two patients (6.9%). Dry and scaly skin of the eyelids was seen in one pat ient (3.4%). Lens opacities were found in 2 (33.3%) of 6 irradiated patient s and 2 (8.7%) of 23 nonirradiated patients. Two patients (6.9%) had fundus changes, one with unilateral epiretinal membrane and the other with bilate ral multiple discrete chorioretinal hypopigmented lesions in the middle to peripheral part of the retina. The overall complication rates for the anter ior and posterior segments were 75.8% and 6,9%, respectively. Conclusion: Ocular manifestations of BMT in children are not uncommon. The most common anterior segment problem is tear dysfunction, Posterior segment complications are less common but do exist, High rate of cataract formatio n is reported, and this probably is the most important long-term "amblyogen ic" problem in these immature eyes, Awareness and management of these probl ems with routine eye examination and early intervention are recommended.