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   Table of Contents      
LETTER TO EDITOR
Year : 2004  |  Volume : 52  |  Issue : 3  |  Page : 255-6

Major ocular complications after organ transplantation.


Correspondence Address:
S Mehta


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Source of Support: None, Conflict of Interest: None


PMID: 15510473

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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

How to cite this URL:
Mehta S. Major ocular complications after organ transplantation. Indian J Ophthalmol [serial online] 2004 [cited 2020 Jun 4];52:255. Available from: http://www.ijo.in/text.asp?2004/52/3/255/14576

Dear Editor,

I read with interest the editorial by Lanzetta et al. [1] 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.[2] 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.[3] 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.[4] 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 [5] with the risk of ocular disease. Reactivation of existing ocular toxoplasmosis has also been noted.

Das and coworkers[6] 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 Top

1.
Lanzetta P, Monaco P. Major Ocular Complications after Organ Transplantation. Indian J Ophthalmol 2004;52:95-97.  Back to cited text no. 1
[PUBMED]    
2.
Sakhuja V, Jha V, Varma PP, Joshi K, Chugh KS. The high incidence of tuberculosis among renal transplant recipients in India. Transplantation 1996;61:211-15.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.
Moon SJ, Mieler WF. Retinal Complications of Transplantation. Curr Op Ophthalmol 2003;14:433-42.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.
Coskuncan NM, Jabs DA, Dunn JP. The eye in bone marrow transplantation. VI. Retinal Complication. Arch Ophthalmol 1994;112:372-79.  Back to cited text no. 4
    
5.
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 2003;75:1544-51.  Back to cited text no. 5
    
6.
Das T, Gupta A, Sakhuja V, Gupta KL, Minz M, Chugh KL. Ocular Complications In Renal Allograft Recipients. Nephrol Dial Transpl 1991;6:649-55.  Back to cited text no. 6
    



This article has been cited by
1 Ophthalmoscopy in the early diagnosis of opportunistic tuberculosis following renal transplant
Mehta, S., Suratkal, L.
Indian Journal of Ophthalmology. 2007; 55(5): 289-391
[Pubmed]



 

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