Ocular findings in allogeneic stem cell transplantation without total bodyirradiation

Objective: To evaluate the ophthalmologic complications in hematologic pati ents after allogeneic stem cell transplantation (ASCT) without total body i rradiation. Design: Retrospective noncomparative case series. Participants: A total of 150 ASCT patients. Intervention: Ophthalmologic examinations of 130/150 patients were made, wi th particular attention to the occurrence of graft-versus-host disease (GVH D). Results: One hundred thirty patients with a mean age of 35.5 (SD 10.6) year s at the time of ASCT were followed up for a mean of 12 months (range 3-60 months). GVHD developed in 73 patients (56.2%). Of 130 patients, 52 (40.0%) had ocular complications, and 29 (22.3%) of those had GVHD. Keratoconjunct ivitis sicca was diagnosed in 13 (10.0%) patients, and 12 (9.2%) had differ ent stages of pseudomembranous conjunctivitis. Cataract developed in 3 pati ents (2.3%) in the observation period, and 7 (5.4%) had keratitis. Six (4.6 %) patients had uveitis, and 8 (6.2%) had retinal hemorrhages. No ischemic retinopathy was found. Bilateral optic disc edema developed in 10 (7.7%) pa tients. Conclusions: Fewer ocular complications were observed in this series than i n earlier studies, and the visual outcome was favorable. Cyclosporine has b een linked to the development of optic disc edema and ischemic retinal lesi ons. The latter condition was not observed in the study patients, and the o ptic disc edema resolved within 1 year in all patients without any detectab le visual impairment, in spite of continuation of the drug. Seven patients had acute GVHD at the time of optic disc edema, which is considered to be a nother manifestation of acute GVHD.