Abstract
Purpose: :
To describe ocular complications in lung transplant patients.
Methods: :
Records of patients who have undergone lung transplantation from January 1998 to September 2008 at Cleveland Clinic were reviewed. Patients evaluated at the Cole Eye Institute after lung transplant were included.
Results: :
46/545 patients received ophthalmology follow-up after lung transplant. Ocular infections occurred in 5/46 (10.9%) of patients. Fungal infection was diagnosed in three patients; Rhino-orbital mucormycosis in one patient, disseminated Pseudoallescheria boydii infection in two patients. CMV retinitis was diagnosed in one patient and VZV keratouveitis was diagnosed in another. All five patients with ocular infections died within 6 months of evaluation. Decreased absolute lymphocyte count is associated with infectious ocular complications (p=0.0021). The most common non-infectious diagnosis was cataract, found in 19/46 patients (41.3%). Posterior subcapsular cataract was present in 13/19 patients (68.4%). 3 eyes in two patients with end-stage primary pulmonary hypertension developed full-thickness macular holes associated with serous macular detachments.
Conclusions: :
Many ocular conditions can occur in lung transplant patients. Serous macular detachment with macular hole can be seen in transplant patients with end-stage primary pulmonary hypertension. Ocular infectious complications are uncommon but can be associated with mortality.
Keywords: transplantation • fungal disease • immunomodulation/immunoregulation