Ocular complications in patients with lung transplants

Tarabishy, Ahmad B.; Khatib, Omar F.; Nocero, John; Budev, Marie

doi:10.1136/bjo.2010.191585

Cited by 15 publications

(5 citation statements)

References 12 publications

(9 reference statements)

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“…Tarabishy et al reported the finding in 13 (28.3%) out of 46 lung transplant recipients, making it the most common ophthalmologic complication in this population (59). Data from other SOT recipients show a similar trend.…”

Section: Posterior Subcapsular Cataract (Psc)mentioning

confidence: 57%

“For your eyes only”: ophthalmic complications following lung transplantation

et al. 2018

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Ophthalmic complications in the lung transplant population are a little-known entity. It includes a spectrum of diseases ranging from infections such as cytomegalovirus (CMV) retinitis, herpetic keratitis, Pseudallescheria boydii to non-infectious complications such as posterior subcapsular cataracts (PSCs), cyclosporine retinopathy, and post-transplant lymphoproliferative disorder (PTLD). These diseases can be attributed to high levels of immunosuppression, advanced age, and drug-specific side effects. Underlying comorbidities such as diabetes mellitus may also play a role in the pathogenesis. Patients can present with varied symptoms such as blurry vision, floaters or eye pain. Prompt diagnosis often requires a high index of suspicion. With increasing numbers of transplants being performed worldwide, it is imperative for the pulmonologist and transplant physician to recognize these often subtle symptoms. Any visual symptom should trigger an ophthalmological evaluation in order to manage these complications; some of which pose the risk of systemic dissemination and significant morbidity. The following article provides an indepth review of the common presenting symptoms, treatments and recent advances related to common ophthalmic complications following lung transplantation. While this article focuses on the lung transplant sub-population, the authors would like to point out that some of these complications are shared by other solid-organ transplants as well, by virtue of their shared immunosuppressive therapies.

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Section: Posterior Subcapsular Cataract (Psc)mentioning

confidence: 57%

“For your eyes only”: ophthalmic complications following lung transplantation

et al. 2018

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“…We found reports on 121 cases of mucormycosis in LTR. Data regarding infection site and outcome were available for 53 patients (Figure ), whereas detailed clinical and therapeutic data were available for 34 patients, for which the data regarding our series were also added, to total 40 patients (Table ) . Thirty‐four of the 121 published cases referred to airway colonization with Mucorales without clinical, radiological, or histological evidence of invasive disease; however, some cases affected management, leading to reduced immunosuppression or to initiation of antifungal therapy .…”

Section: Resultsmentioning

confidence: 99%

Mucormycosis in lung transplant recipients: A systematic review of the literature and a case series

Wand

Unterman

Izhakian

et al. 2020

Clinical Transplantation

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Background Mucormycosis is a rare infection in lung transplant recipients (LTR). Our objective was to better define the clinical presentation and optimal management of this frequently lethal infection. Methods A systematic review of the literature was performed to identify all published cases of mucormycosis in LTR using PubMed/MEDLINE. These cases were analyzed together with a new case series from our clinic. Results Literature search yielded 44 articles matching the inclusion criteria, describing 121 cases. Six additional cases were identified from our clinic. Data regarding infection site and outcome were available for a total of 53 patients. The lungs were the most common site of infection (62%), followed by rhinocerebral and disseminated disease. Most cases (78%) developed in the first post‐transplant year, with over 40% of them in the first month. Additional risk factors for mucormycosis were identified in over half of the patients. Surgical debridement was uncommon in pulmonary infection (9%). Posaconazole therapy was used in 35% of cases, mostly in combination with amphotericin B. Overall mortality was 32% but varied according to site of infection. Conclusion Mucormycosis in LTRs tends to be an early post‐surgical infection, associated with additional risk factors and intensified immunosuppressive states, and most often affects the lungs, where surgical debridement is rarely feasible. Posaconazole as first‐line therapy should be further explored.

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“…Tarabishy et al found that the most common ocular abnormality following lung transplant was posterior subcapsular cataract, followed by infectious ocular complications 34 . High levels of immunosuppression, advanced age, drug-specific side effects, underlying comorbidities such as diabetes mellitus, have been suggested to play a role in pathogensis 35 .…”

Section: Discussionmentioning

confidence: 99%

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

Rady

Kini

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeRecognize a rare yet existing risk of severe visual loss as a postoperative complication of bilateral lung transplant.ObservationsA 62-year-old male had undergone bilateral lung transplant for end-stage idiopathic pulmonary fibrosis and emphysema overlap syndrome. The operation was initially off-pump; however, during the left lung transplantation, cardiopulmonary bypass conversion was necessary to maintain intraoperative hemodynamic stability. On post-operative day 4, shortly after extubation and full recovery from sedation, the patient reported bilateral no light perception vision. There were no other associated neurologic symptoms. A computed tomographic (CT) of the head, cranial magnetic resonance (MR) scan of the head, MR angiogram of the circle of Willis and neck were negative. Neuro-ophthalmologic examination revealed no light perception vision in both eyes(OU). The pupils were non-reactive to light (amaurotic pupils). The intraocular pressure measured 18 mm Hg OU, and complete bilateral ophthalmoplegia was present. The fundus exam showed bilateral pallid optic disc edema, cherry red spots, with arteriolar attenuation, and mildly dilated and tortuous veins. Stroke work up was negative.Conclusions and importanceA case of post-operative visual loss and ophthalmoplegia carrying significant and permanent quality of life implications. It questions the role disruption of homeostasis during cardiopulmonary bypass contributes for this outcome.

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Ocular complications in patients with lung transplants

Abstract: Many ocular conditions can occur in patients with lung transplants. Ocular infectious complications were uncommon but may be associated with increased mortality.

Cited by 15 publications

References 12 publications

“For your eyes only”: ophthalmic complications following lung transplantation

“For your eyes only”: ophthalmic complications following lung transplantation

Mucormycosis in lung transplant recipients: A systematic review of the literature and a case series

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

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