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Atypical retinal microvasculopathy after bone marrow transplantation
1Department of Ophthalmology, Royal Melbourne Hospital, Victoria, Australia. guybron@hotmail.com
Clinical & Experimental Ophthalmology
|September 8, 2001
Summary
A rare, late-onset retinopathy can occur after allogeneic bone marrow transplantation (BMT). This non-ischaemic condition presents with microaneurysms and good vision, differing from typical early BMT-related retinal changes.
Area of Science:
- Ophthalmology
- Hematology
- Transplantation Medicine
Background:
- Allogeneic bone marrow transplantation (BMT) is associated with known early retinal microvascular changes, often presenting as cotton wool spots.
- This study focuses on a less common, atypical retinopathy developing late after BMT.
Observation:
- A review of late retinal microvasculopathy cases post-BMT identified four patients with atypical retinopathy.
- These patients, all male aged 27-50, developed retinopathy 13-62 months after BMT, unrelated to hypertension or diabetes.
- Clinical presentation included microaneurysms, hard exudates, and macular edema, notably without cotton wool spots.
Findings:
- Angiography revealed microaneurysms in all affected patients, with some exhibiting late leakage and peripheral or central ischemia.
- Despite the retinopathy, median visual acuity remained good at 6/5.
- Only one patient required intervention (focal photocoagulation) for macular edema.
Implications:
- Atypical, non-ischaemic retinopathy is a potential late complication of allogeneic BMT.
- This condition is characterized by retinal microvascular incompetence and can occur with preserved visual acuity.
- Ophthalmologists should consider BMT history in patients presenting with late-onset retinal vascular changes.