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Updated: Aug 28, 2025

Competitive Transplants to Evaluate Hematopoietic Stem Cell Fitness
Published on: August 31, 2016
Posterior segment complications and the risk factors after allogeneic hematopoietic stem cell transplantation
Boyu Yang1, Shaowen Wu1, Shanshan Yu1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Insights
Posterior segment complications (PSC) after allogeneic hematopoietic stem cell transplantation (HSCT) are more common than previously thought. Unrelated or HLA-mismatched donors increase the risk of PSC in HSCT patients.
Area of Science:
- Ophthalmology
- Hematology
- Transplantation Medicine
Background:
- Allogeneic hematopoietic stem cell transplantation (HSCT) is a life-saving procedure.
- Posterior segment complications (PSC) can affect visual outcomes in HSCT recipients.
- Understanding risk factors for PSC is crucial for patient management.
Purpose of the Study:
- To investigate the prevalence of PSC in patients undergoing allogeneic HSCT.
- To identify risk factors associated with the development of PSC post-HSCT.
- To evaluate the relationship between PSC and ocular Graft-versus-Host Disease (oGVHD).
Main Methods:
- A cross-sectional, case-control study included 143 allogeneic HSCT patients.
- Comprehensive ocular examinations assessed PSC and oGVHD.
- Diagnostic tools included fundus examinations, visual-evoked potential, and oGVHD scoring systems.
Main Results:
- PSC was detected in 25.2% of patients.
- Cytomegalovirus retinitis (9.1%) and visual pathway pathology (4.9%) were the most common PSC.
- PSC was significantly associated with unrelated (OR=6.494) and HLA-mismatched (OR=7.193) donors.
Conclusions:
- PSC is a notable complication following HSCT, occurring more frequently than previously recognized.
- Ophthalmologists should be vigilant for PSC in HSCT patients.
- Patients receiving transplants from unrelated or HLA-mismatched donors require particular attention for PSC risk.
Purpose:
To study the posterior segment complications (PSC) and the risk factors in patients after allogeneic hematopoietic stem cell transplantation (HSCT).
Methods:
This cross-sectional, case-control study enroled 143 patients who received allogeneic HSCT. Comprehensive ocular examinations were performed to evaluate PSC and ocular Graft-versus-Host Disease (oGVHD). PSC was diagnosed based on the characteristic fundus findings and auxiliary examinations. Visual-evoked potential was examined in patients with unexplained visual loss and suspected visual pathway pathology (VPP). Ocular surface disease index, corneal fluorescein staining, conjunctival injection and Schirmer's test were scored to diagnose oGVHD.
Results:
PSC was detected in 36 (25.2%) patients, while 107 (74.8%) patients were not. Among them, 102 (71.3%) patients were diagnosed with oGVHD. The most common PSC included cytomegalovirus retinitis (13/143, 9.1%) and VPP (7/143, 4.9%). Central nervous system relapse of leukaemia was detected in four out of seven cases of VPP. Patients with PSC had worse visual acuity, lower prevalence and milder severity of oGVHD, and more donors from unrelated and human leucocyte antigen (HLA)-mismatch (all P < 0.05). PSC was associated with transplant from unrelated (OR = 6.494, 95% CI: 1.635-25.794, P = 0.008) and HLA-mismatched (OR = 7.193, 95% CI: 2.829-18.291, P < 0.001) donor but not with the occurrence of systemic GVHD or oGVHD.
Conclusions:
PSC in post-HSCT patients was more common than previously noted, deserving the concern of ophthalmologists, especially in patients with unrelated or HLA-mismatched donors.
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