Histopathology and ultrastructure of busulfan-induced cataract

Abstract

A 49-year-old man with chronic myelogenous leukemia developed dense posterior subcapsular cataracts and punctate cortical opacities after five years of busulfan (Myleran) therapy. We found that the histopathologic appearance of busulfan-induced cataracts is similar to other forms of human and experimental cataracts, regardless of cause. Ultrastructural examination revealed cortical liquefaction with formation of Morgagnian droplets, involving primarily the region from the equator to the posterior subcapsular space. In contrast to previous findings in rats, we observed posterior migration of equatorial nuclei and bladder cell formation. Also present were socalled crystalloid rays and abundant degenerate lens fiber membranes manifested as mutli-layered, irregularly folded configurations resembling myelin figures.

Posterior fibrous pseudometaplasia of lens epithelial cells in phacic eyes filled with silicone oil

“…Posterior subcapsular cataract formation has also been observed in senile [6], busulfan-induced [14], complicated [23] and steroid-induced cataracts [6]. The common features of these lens changes include posterior migration of lens epithelial cells.…”

Toxicidad ocular de la quimioterapia sistémica anticancerosa

“…5,17 The keratopathy occurs in the form of subepithelial deposits, whorls and linear opacities. 17 Posterior subcapsular cataract can occur with busulphan, 5,[18][19][20] methotrexate, 5 toremifene and tamoxifen. [21][22][23] In a prospective study of breast cancer patients treated with tamoxifen and toremifene, annual cataract rates were found to be 6.8% and 6.2% respectively.…”