OBJECTIVE: To determine the incidence and time course of retinal and optic-disk ischemia after bone marrow transplantation and to describe the clinical, fluorescein-angiographic, and histologic findings in patients with these ischemic fundus lesions. DESIGN: Prospective cohort study; standardized clinical and ophthalmologic evaluation of all patients before bone marrow transplantation and 3, 6, and 12 months after transplantation (and when indicated). SETTING: University hospitals in Basel, Switzerland. PATIENTS: Consecutive patients (127) treated with allogeneic or autologous bone marrow grafts. MAIN RESULTS: Thirteen of the 127 patients (10%; 95% Cl, 5% to 15%) had lesions of the ocular microcirculation. All patients had cotton-wool spots in the fundus of both eyes, and three patients also had bilateral optic-disk edema. Secondary changes included retinal hemorrhages and lipid deposits. The ischemic fundus lesions appeared during the first 6 months after transplantation and were reversible in 9 of the 13 patients. The lesions occurred only in patients who were treated with total body irradiation and were given cyclosporin A as prophylaxis for graft-versus-host disease. CONCLUSIONS: Ischemic fundus lesions are a frequent complication after bone marrow transplantation. They were only observed in patients treated with total body irradiation and cyclosporin A. This combination of therapy appears to have an additive effect on the development of ocular and possibly generalized microvascular lesions.
OBJECTIVE: To determine the incidence and time course of retinal and optic-disk ischemia after bone marrow transplantation and to describe the clinical, fluorescein-angiographic, and histologic findings in patients with these ischemic fundus lesions. DESIGN: Prospective cohort study; standardized clinical and ophthalmologic evaluation of all patients before bone marrow transplantation and 3, 6, and 12 months after transplantation (and when indicated). SETTING: University hospitals in Basel, Switzerland. PATIENTS: Consecutive patients (127) treated with allogeneic or autologous bone marrow grafts. MAIN RESULTS: Thirteen of the 127 patients (10%; 95% Cl, 5% to 15%) had lesions of the ocular microcirculation. All patients had cotton-wool spots in the fundus of both eyes, and three patients also had bilateral optic-disk edema. Secondary changes included retinal hemorrhages and lipid deposits. The ischemic fundus lesions appeared during the first 6 months after transplantation and were reversible in 9 of the 13 patients. The lesions occurred only in patients who were treated with total body irradiation and were given cyclosporin A as prophylaxis for graft-versus-host disease. CONCLUSIONS:Ischemic fundus lesions are a frequent complication after bone marrow transplantation. They were only observed in patients treated with total body irradiation and cyclosporin A. This combination of therapy appears to have an additive effect on the development of ocular and possibly generalized microvascular lesions.
Authors: Yoshihiro Inamoto; Igor Petriček; Linda Burns; Saurabh Chhabra; Zachariah DeFilipp; Peiman Hematti; Alicia Rovó; Raquel Schears; Ami Shah; Vaibhav Agrawal; Aisha Ahmed; Ibrahim Ahmed; Asim Ali; Mahmoud Aljurf; Hassan Alkhateeb; Amer Beitinjaneh; Neel Bhatt; Dave Buchbinder; Michael Byrne; Natalie Callander; Kristina Fahnehjelm; Nosha Farhadfar; Robert Peter Gale; Siddhartha Ganguly; Shahrukh Hashmi; Gerhard C Hildebrandt; Erich Horn; Ann Jakubowski; Rammurti T Kamble; Jason Law; Catherine Lee; Sunita Nathan; Olaf Penack; Ravi Pingali; Pinki Prasad; Drazen Pulanic; Seth Rotz; Aditya Shreenivas; Amir Steinberg; Khalid Tabbara; André Tichelli; Baldeep Wirk; Jean Yared; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw; Nuria Valdés-Sanz Journal: Biol Blood Marrow Transplant Date: 2018-12-03 Impact factor: 5.742
Authors: Yoshihiro Inamoto; Igor Petriček; Nuria Valdés-Sanz; Linda Burns; Saurabh Chhabra; Zack DeFilipp; Peiman Hematti; Alicia Rovó; Raquel Schears; Ami Shah; Vaibhav Agrawal; Aisha Al-Khinji; Ibrahim Ahmed; Asim Ali; Mahmoud Aljurf; Hassan Alkhateeb; Amer Beitinjaneh; Neel Bhatt; Dave Buchbinder; Michael Byrne; Natalie Callander; Kristina Fahnehjelm; Nosha Farhadfar; Robert Peter Gale; Siddhartha Ganguly; Gerhard C Hildebrandt; Erich Horn; Ann Jakubowski; Rammurti T Kamble; Jason Law; Catherine Lee; Sunita Nathan; Olaf Penack; Ravi Pingali; Pinki Prasad; Drazen Pulanic; Seth Rotz; Aditya Shreenivas; Amir Steinberg; Khalid Tabbara; André Tichelli; Baldeep Wirk; Jean Yared; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw Journal: Bone Marrow Transplant Date: 2019-02-27 Impact factor: 5.483