IngentaConnect Visual outcome and cataract development after allogeneic stem-cel...

Authors: Fahnehjelm, Kristina Teär; Törnquist, Alba-Lucia¹; Olsson, Monica²; Winiarski, Jacek³

Source: Acta Ophthalmologica Scandinavica, Volume 85, Number 7, November 2007 , pp. 724-733(10)

Abstract:

. Purpose:

To report visual functions and prevalence of cataract after haematopoetic stem-cell transplantation (SCT) during childhood and to determine the impact of different conditioning regimes and other possible risk factors. Methods:

Assessment of visual acuity (VA), slit-lamp biomicroscopy of the lenses and examination of the ocular fundii were performed in 79 subjects 2-18 years (median 7 years) after SCT. Results:

Best-corrected decimal VA ≥ 0.5 was achieved in 152/158 eyes (96%). There was an increased risk of cataract after conditioning with single-dose total body irradiation (s-TBI) or fractionated TBI (f-TBI) compared to busulfan or other chemotherapy (P < 0.001) and an increased risk of developing cataract earlier if treated with s-TBI compared to f-TBI (P < 0.01). The TBI mode did not affect the time to first surgical intervention. Apart from s-TBI and f-TBI, age was found to be an independent risk factor. Cataract also developed in patients prepared with chemotherapy but no patient required surgery. Neither treatment with steroids for 6 months or longer nor history of chronic graft versus host disease (GVHD) influenced cataract development. Conclusion:

Conditioning with full dose f-TBI compared to s-TBI postpones but does not prevent cataract or cataract surgery while chemotherapy-based conditioning induces less severe cataracts, usually not requiring surgery. Corticosteroids or GVHD do not appear as risk factors.

Keywords: cataract; graft versus host disease; stem-cell transplantation; steroids; total body irradiation

Document Type: Research article

DOI: 10.1111/j.1600-0420.2007.00991.x

Affiliations: 1: Department of Clinical Neuroscience, Unit of Optometry, St Erik's Eye Hospital, Stockholm, Sweden 2: Department of Paediatric Ophthalmology and Strabismus, St Erik's Eye Hospital, Karolinska University Hospital, Huddinge, Stockholm, Sweden 3: Department of Clinical Science and Technology, Karolinska Institutet and Department of Paediatrics, Karolinska University Hospital, Huddinge, Stockholm, Sweden

You have access to the full text article on a website external to Ingentaconnect.

Please click here to view this article on InterScience.

You may be required to register and activate access on InterScience before you can obtain the full text. If you have any queries please contact onlinehelp@oxon.blackwellpublishing.com

Visual outcome and cataract development after allogeneic stem-cell transplantation in children