Related Experiment Videos
Late ocular complications after bone marrow transplantation
1Department of Internal Medicine, University Hospital, Basel, Switzerland.
Nouvelle Revue Francaise D'Hematologie
|January 1, 1994
Summary
Bone marrow transplantation (BMT) can cause late ocular complications, including microvasculopathy and cataracts. Total body irradiation (TBI) is a significant risk factor for these vision-threatening conditions.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Bone marrow transplantation (BMT) is associated with several late ocular complications.
- These include microvasculopathy, cataract formation, and keratoconjunctivitis sicca.
Purpose of the Study:
- To evaluate the incidence and risk factors of late ocular complications after BMT.
- Specifically focusing on microvasculopathy and cataract formation.
Main Methods:
- Retrospective analysis of ocular findings in 127 patients post-BMT for microvasculopathy.
- Evaluation of cataract formation in 197 patients post-BMT.
- Correlation of ocular complications with conditioning regimens, including total body irradiation (TBI) and chemotherapy, and graft-versus-host disease (GvHD) treatment with cyclosporine A.
Main Results:
- Ocular microvasculopathy (cotton wool spots, hemorrhages, edema, lipoid deposits) occurred in 10.3% of patients, exclusively in those receiving TBI and cyclosporine A.
- Cataract formation was observed in 36% of patients, with 23% requiring surgery.
- Single-dose TBI led to lens opacification in all survivors at 3.5 years; fractionated TBI showed a 29% cataract risk at 3.5 years and 83% at 6 years. Chemotherapy alone had a low cataract incidence.
Conclusions:
- Total body irradiation (TBI) and its fractionation are major risk factors for post-BMT cataract development.
- Ocular microvasculopathy appears linked to TBI and cyclosporine A, suggesting a systemic capillary process.
- Preventive strategies, like lens shielding during TBI, should be considered to mitigate these ocular risks.