|LETTER TO EDITOR
|Year : 2004 | Volume
| Issue : 3 | Page : 255-6
Major ocular complications after organ transplantation.
Source of Support: None, Conflict of Interest: None
Keywords: Eye Diseases, etiology, microbiology, Humans, Opportunistic Infections, complications, epidemiology, Organ Transplantation, adverse effects, Prevalence
|How to cite this article:|
Mehta S. Major ocular complications after organ transplantation. Indian J Ophthalmol 2004;52:255
I read with interest the editorial by Lanzetta et al.  In this communication the role of opportunistic infections as a cause of visual morbidity was not addressed.
Tuberculosis remains an important endemic infection in India and patients of organ or bone marrow transplant remain vulnerable due to their depressed cell-mediated immunity. The incidence of systemic tuberculosis following renal transplantation in India is high, at 12-20%, and is responsible for the high mortality. Furthermore, the infection is commonly disseminated or is extrapulmonary. Though few cases have been reported, there is a real risk of ocular involvement. We have recently reported a case of ocular tuberculosis in a patient of renal allograft (submitted).
Cytomegalovirus (CMV) retinitis is a common infection worldwide in immunosuppressed patients, with a prevalence of up to 1% following bone marrow transplants and 2-15% following solid organ transplants. The visual outcome of this infection may be devastating.
Fungal ( Candida and Aspergillus sp.) retinitis or endophthalmitis has commonly been reported in the Western literature. In India, systemic fungal infections including Candida , Nocardia and Aspergillus have been reported in 6.3% of patients after renal allograft and in 15.9% following bone marrow transplants  with the risk of ocular disease. Reactivation of existing ocular toxoplasmosis has also been noted.
Das and coworkers found infectious complications (CMV, mucormycosis and herpes simplex) in 5 of 80 (6.25%) post-renal allograft patients. Similar studies are lacking but significant under-reporting probably exists. Ocular examination may have a role in the diagnosis of these infections as well as in preventing consequent visual morbidity.
| References|| |
Lanzetta P, Monaco P. Major Ocular Complications after Organ Transplantation. Indian J Ophthalmol
Sakhuja V, Jha V, Varma PP, Joshi K, Chugh KS. The high incidence of tuberculosis among renal transplant recipients in India. Transplantation
Moon SJ, Mieler WF. Retinal Complications of Transplantation. Curr Op Ophthalmol
Coskuncan NM, Jabs DA, Dunn JP. The eye in bone marrow transplantation. VI. Retinal Complication. Arch Ophthalmol
Tharayil JG, Shankar V, Talaulikar G, Mathews MS, Abraham M, Punnakuzhathil TP, et al. Epidemiology of systemic mycoses among renal-transplant recipients in India. Transplantation
Das T, Gupta A, Sakhuja V, Gupta KL, Minz M, Chugh KL. Ocular Complications In Renal Allograft Recipients. Nephrol Dial Transpl