Dry Eye Disease Prevalent in Adolescents After Allogeneic Bone Marrow Transplantation
In this retrospective cohort study, 162 patients between the ages of 7 and 18 years (mean age of 13.4 years) who underwent a bone marrow transplantation were included. Patient were followed from 13 months to 12 years (mean 4 years, median 3.2 years) and charts were screened for cataract formation, dry eye, and other anterior and posterior segment disease.
Dry eyes developed in 51 of the 162 patients, with age at transplantation, steroid use, chronic graft-versus-host disease, fludarabine use, melphalan use, thiotepa use, and receiving no pre-transplant conditioning regimen prior to bone marrow transplant significantly increasing the risk of dry eye syndrome (P < 0.05). A multivariate analysis showed that chronic graft-versus-host disease was a significant risk factor for dry eye syndrome.
In addition, cataracts were noted in 57 patients, with 4 (6 eyes) patients requiring cataract surgery. Fractionated total body irradiation, race, and use of cytarabine significantly increased the incidence of cataracts forming (P < 0.05). A multivariate analysis of significant variables showed that total body irradiation was a risk factor for cataract formation.
The study authors concluded that adolescent and school-age children who have had an allogeneic bone marrow transplant should be screened yearly by a pediatric of general ophthalmologist.
Hoehn ME, Vestal R, Calderwood J, et al. Ocular complications in school-age children and adolescents after allogeneic bone marrow transplantation. Am J Ophthalmol. 2020 Jan 2019 [Online ahead of print]. DOI: 10.1016/j.ajo.2020.01.025