Microvasculopathy in the Ocular Fundus after Bone Marrow Transplantation

Abstract

Ischemic fundus lesions are a frequent complication after bone marrow transplantation. They were only observed in patients treated with total body irradiation and cyclosporin A. This combination of therapy appears to have an additive effect on the development of ocular and possibly generalized microvascular lesions.

Optic disc and retinal microvasculopathy after high-dose chemotherapy and autologous hematopoietic progenitor cell support

“…This syndrome may be different to the one previously described after allogeneic transplants using TBI and cyclosporin A. [5][6][7] All 10 patients who developed symptomatic ocular toxicity in the present series received cisplatin and BCNU, drugs known to cause ocular complications as described above. The fundus lesions appeared to be due to ischemic microvascular effects rather than direct retinal or optic nerve toxicity, making cisplatin less likely as the sole etiologic agent.…”

“…The use of TBI as part of the conditioning regimen and/or cyclosporin A for the prevention of GVHD have been reported to cause ischemic microvasculopathy in the ocular fundus. 5,6 Vogler et al 7 reported ophthalmologic toxicities after autologous and allogeneic BMT for leukemia. They found symptomatic microvascular changes (CWS, capillary nonperfusion, macular edema and neovascularization) in the fundi of seven leukemic patients all of whom received TBI and high-dose cytosine arabinoside and most received prophylactic whole brain irradiation, as well as intrathecal methotrexate.…”

Late-onset persistent retinal microvascular changes after bone marrow transplantation: 3-year follow-up

“…Ischemic fundus lesions after bone marrow transplantation have been reported since 1983 (1) . Typical lesions are bilateral and localized in the posterior pole and around the optic nerve head (2) . They usually appear 3 to 6 months (2)(3) after bone marrow transplantation and have a spontaneous complete resolution in some months.…”

“…Typical lesions are bilateral and localized in the posterior pole and around the optic nerve head (2) . They usually appear 3 to 6 months (2)(3) after bone marrow transplantation and have a spontaneous complete resolution in some months. Here we report a case of a late-onset and persistent BMT retinopathy with appearance of new cotton-wool exudates after three years of the diagnosis of the disease and presumably related to a previous immunosuppressive therapy.…”

Fatal chemotherapy-induced encephalopathy following high-dose therapy for metastatic breast cancer: a case report and review of the literature

“…Changes including cognitive dysfunction with memory problems and ophthalmologic disorders including retinitis have been described. 1 The ophthalmic disorders that have been reported include retinopathy, optic neuritis and rare cases of cortical blindness. 2,3 Patients typically present with decreasing visual acuity, visual field blurring, visual field shadows, visual field loss or global visual loss.…”