DIFFUSE CHORIORETINOPATHY WITHOUT SEROUS DETACHMENT ASSOCIATED WITH CARDIAC TRANSPLANTATION

Area of Science:

• Ophthalmology
• Cardiology
• Transplantation Medicine

Background:

• Cardiac transplantation is a life-saving procedure for end-stage heart failure.
• Post-transplant complications can affect various organ systems, including the eye.
• Widespread chorioretinopathy is an unusual ocular complication following cardiac transplantation.

Observation:

• A 44-year-old woman developed widespread chorioretinopathy six months after cardiac transplantation.
• Ocular examination revealed retinal pigment epithelium (RPE) changes, fragmented ellipsoid and interdigitation zones, and mild electroretinography abnormalities.
• Indocyanine green angiography showed arteriolar remodeling, suggesting a potential ischemic event.

Findings:

• The patient presented with diffuse RPE damage and peripheral retinal involvement without serous retinopathy or leakage.
• Spectral domain optical coherence tomography (SD-OCT) demonstrated RPE thinning and outer retinal structural disruption.
• Electroretinography indicated mild rod and cone dysfunction.

Implications:

• The findings suggest a possible transient choroidal ischemic event during or shortly after cardiac surgery as the etiology.
• Diffuse transplant choriorioretinopathy may be an underdiagnosed condition in post-cardiac transplant patients.
• Routine peripheral retinal examinations are recommended for early detection and management of ocular complications in this patient population.