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Published on: March 21, 2017
Ocular findings after bone marrow transplantation in a pediatric population
D W Suh1, M S Ruttum, B J Stuckenschneider
1The Eye Institute, Medical College of Wisconsin, Milwaukee 53226-4812, USA.
Insights
Pediatric bone marrow transplantation (BMT) can lead to significant ocular complications, including dry eye and cataracts, in over half of patients. However, most children maintain good vision after BMT.
Area of Science:
- Ophthalmology
- Pediatric Hematology
- Bone Marrow Transplantation
Background:
- Bone marrow transplantation (BMT) is increasingly used for pediatric hematologic diseases.
- Ocular complications following BMT in children are a growing concern.
Purpose of the Study:
- To determine the prevalence and types of ocular abnormalities in pediatric patients post-BMT.
- To identify risk factors associated with these complications.
Main Methods:
- Retrospective study of 104 pediatric patients undergoing BMT.
- Evaluations included visual acuity and comprehensive eye examinations (slit-lamp, funduscopy).
Main Results:
- Ocular changes occurred in 51% of patients.
- Common findings: cataracts (23.0%), posterior segment complications (13.5%), and dry eye syndrome (12.5%).
- 95.7% of eyes achieved a final visual acuity of 20/40 or better.
Conclusions:
- Pediatric BMT patients are at risk for severe, vision-threatening ocular complications.
- Despite high incidence, most patients retain good visual function.
- Risk factors include underlying disease, irradiation, chemotherapy, graft-versus-host disease, and immunosuppression.
Purpose:
With the increasing use of bone marrow transplantation (BMT) in children to treat diseases of the hematopoietic system, ocular complications have been recognized in greater numbers. The authors performed a retrospective study to determine the prevalence and types of ocular abnormalities in a pediatric population following BMT.
Design:
Retrospective noncomparative study.
Participants:
One hundred and four consecutive pediatric patients with aplastic anemia and various hematologic malignancies who required BMT.
Intervention:
Bone marrow transplantation.
Main Outcome Measures:
Visual acuity and slit-lamp biomicroscopic and funduscopic examinations.
Results:
Ocular changes developed in 51% of patients. The most frequent findings included dry eye syndrome (12.5%), cataract (23.0%), and posterior segment complications (13.5%). A final visual acuity of 20/40 or better was achieved in 95.7% of eyes.
Conclusions:
Pediatric patients can develop severe and potentially vision-threatening complications following BMT. Despite the high incidence of anterior and posterior segment abnormalities, ocular symptoms were generally mild and the majority of patients retained excellent visual function. Factors associated with ocular complications included the underlying disease, total body irradiation, systemic chemotherapy, graft-versus-host disease, and immunosuppression. Familiarity with these risk factors and potential complications in pediatric patients is important for successful treatment.
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