Abstract
ABSTRACTObjective To evaluate retinal changes in patients who underwent solid organ or bone marrow transplantation.Methods A retrospective analysis of medical records of patients evaluated from February 2009 to December 2016. All patients included underwent funduscopy. Clinical and demographic data regarding transplantation and ophthalmological changes were collected.Results A total of 126 patients were analyzed; of these, 108 underwent transplantation and 18 were in the waiting list. Transplantation modalities were heart, lung, kidney, liver, pancreas, combined pancreas and kidney and bone marrow transplantation. The main pre-transplantation comorbidities were diabetes and arterial hypertension. Of the 108 transplanted patients, 82 (76%) had retinal changes. All patients who underwent pancreas or combined pancreas and kidney transplantation had diabetic retinopathy. The main retinal changes found were diabetic retinopathy, hypertensive retinopathy, retinal vascular occlusions, chorioretinal infections and central serous chorioretinopathy.Conclusion Retinal changes were either related to preexisting conditions, mainly diabetic retinopathy, or developed postoperatively as a complication of the surgical procedure, or as an infection related to the immunosuppressive status, or due to drug toxicity. These patients may present with complex ophthalmological changes and should be carefully evaluated prior to surgery and further followed by an ophthalmologist skilled in the management of diabetic retinopathy and posterior pole infections.
Highlights
Patients undergoing organ transplantation may present with ocular changes in the pre, peri, or postoperative periods.[1]
A total of 126 patients were analyzed, in that, 108 (86%) were from Transplantation Group and 18 (14%) from Waiting List Group; retinal changes were found in 97 patients
There was a long interval between transplantation and ocular assessment in some patients, with a maximal interval of 142 months, which caused a high standard deviation
Summary
Patients undergoing organ transplantation may present with ocular changes in the pre-, peri, or postoperative periods.[1] These changes may be either related to the deterioration of retinal diseases occurring prior to transplantation, or represent complications of the procedure or the treatment started in the postoperative period. During the postoperative follow-up, these patients undergo immunosuppressive therapy, which may facilitate the onset of opportunistic infections whose target organs are ocular structures such as the retina and choroid.[2] the drugs used in the postoperative management may cause retinal damage due to toxicity or lead to the development of retinal diseases due to secondary metabolic changes.[1]. The Hospital Israelita Albert Einstein (HIAE) has a large solid organ and bone marrow transplantation program. The Diagnostic Center in Ophthalmology (CDOF - Centro de Diagnóstico em Oftalmologia) team of the Instituto Israelita de Responsabilidade Social performs eye evaluations of several patients in this program
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
