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| LETTER TO EDITOR |
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| Year : 2004 | Volume
: 52
| Issue : 3 | Page : 255-6 |
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Major ocular complications after organ transplantation.
S Mehta
Correspondence Address:
S Mehta
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 15510473 
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 |
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 | |  |
| 1. | Lanzetta P, Monaco P. Major Ocular Complications after Organ Transplantation. Indian J Ophthalmol 2004;52:95-97.  [ 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. [ PUBMED] [ FULLTEXT] |
| 3. | Moon SJ, Mieler WF. Retinal Complications of Transplantation. Curr Op Ophthalmol 2003;14:433-42. [ PUBMED] [ FULLTEXT] |
| 4. | Coskuncan NM, Jabs DA, Dunn JP. The eye in bone marrow transplantation. VI. Retinal Complication. Arch Ophthalmol 1994;112:372-79. |
| 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. |
| 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. |
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