December 2002
Volume 43, Issue 13
ARVO Annual Meeting Abstract  |   December 2002
Ocular Pathology in Lung Transplant Recipients
Author Affiliations & Notes
  • MD Conway
    Department of Ophthalmology Tulane University New Orleans LA
  • K Giangrosso
    Department of Ophthalmology Tulane University New Orleans LA
  • LT Young
    Department of Ophthalmology Tulane University New Orleans LA
  • HJ Kaplan
    Department of Ophthalmology University of Louisville Louisville KY
  • C Fry
    Department of Ophthalmology
    Ochsner Clinic New Orleans LA
  • VG Valentine
    Pulmonary and Critical Care Medicine
    Ochsner Clinic New Orleans LA
  • Footnotes
    Commercial Relationships   M.D. Conway, None; K. Giangrosso, None; L.T. Young, None; H.J. Kaplan, None; C. Fry, None; V.G. Valentine, None. Grant Identification: N/A
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 339. doi:
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    • Get Citation

      MD Conway, K Giangrosso, LT Young, HJ Kaplan, C Fry, VG Valentine; Ocular Pathology in Lung Transplant Recipients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):339.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: To describe ocular findings in lung allograft transplant recipients (LTRs) requiring lifelong systemic immunosuppressive therapy. LTRs are at increased risk for serious infections and pharmaceutical complications from chronic use of cyclosporine A (CyA), tacrolimus, azothiaprine and prednisone. Methods: LTRs were referred for ocular evaluation. Two groups of LTRs were identified; younger patients with cystic fibrosis (CF) and older patients with other pulmonary pathology. Their medications and general condition were reviewed. A complete ocular examination including best-corrected visual acuity and a dilated fundus examination were performed on 27 of 80 patients. Results: Twenty seven patients (n=54 eyes) including 17 females and 10 males {average age 42 (range 15-67 yrs)} were examined cross sectionally and five patients were followed longitudinally. Lung transplantation was performed for CF (n=11) {average age 22.5 yrs (range 15-32)}, emphysema (COPD) (n=12), idiopathic pulmonary fibrosis (n=2) and one patient each with bronchoalveolar cell carcinoma, and pulmonary hypertension. Adult patients had an average age of 55.3 years (range 41-67). The median time to follow-up post-transplantation was 22 months (range 6-73). The most frequent ocular findings were cataract (13 eyes) probably secondary to prednisone therapy, retinal vascular tortuosity (10 eyes), Pseudomonas panophthalmitis (4 eyes), Cytomegalovirus (4 eyes), transplant retinopathy (2 eyes), visual field defect after cerebrovascular accident (2 eyes), anterior ischemic optic neuropathy (2 eyes) possibly related to CyA therapy, and branch retinal vein occlusion with cystoid macular edema (1 eye). There were eight patients with diabetes; seven requiring insulin therapy. However, no diabetic retinopathy was identified up to 10 years after the onset of diabetes. Conclusion: LTRs are at a high risk for serious ocular pathology. Although cataracts and retinal vascular tortuosity were most prevalent, other sight-threatening diseases occurred in a significant number of eyes. Careful baseline ophthalmologic examination and follow-up is necessary for early detection and appropriate intervention to prevent visual loss in LTRs.

Keywords: 352 clinical (human) or epidemiologic studies: natural history • 354 clinical (human) or epidemiologic studies: prevalence/incidence • 507 pathology: human 

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