Retina-Vitreous
2007 , Vol 15 , Num 2
The Differential Diagnosis of Retinopathy after Peripheral-Blood Stem Cell Transplantation in Diffuse Large B-Cell Lymphoma
1S.B. Ankara Ulucanlar Göz Eğitim ve Araştırma Hastanesi, Ankara, Uzm. Dr.2S.B. Ankara Ulucanlar Göz Eğitim ve Araştırma Hastanesi, Ankara, Uzm. Dr. A 45-year old man who had been diagnosed with diffuse large B-cell lymphoma at the age of 40 years presented to our clinic with the complaint of bilateral blurred vision 2 months after autologous peripheral blood stem cell transplantation (PBSCT). His visual acuity was 20/20 bilaterally. Anterior segment examination and intraocular pressure were within normal limits in both eyes. Dilated fundus examination revealed flame-shaped and round retinal hemorrhages bilaterally and a cotton-wool spot in the posterior pole of the right eye. According to medical history, he received autologous peripheral blood stem cell transplantation after being treated with a drug regimen of rituximab (375 mg/m2), etoposide (100 mg/m2), carboplatin (25+CrCI), ifosfamide (5000 mg/m2), mesna (5000 mg/ m2) and granulocyte colony-stimulating factor (G-CSF) (mcg/kg), he was given focal neck radiation therapy 8 months ago. When ocular examination was performed, anemia (Hb: 6.1 g/dL), thrombocytopenia (PLT: 42x103 /uL) and leukopenia (WBC: 3x103/uL) was detected in hematologic blood parameters and no chemotherapeutic drug was used at the time of the examination. Retinopathy frequently occurs in various systemic malignant diseases. The use of combined drug regimen, irradiation, anemia and thrombocytopenia are likely to be among the factors playing a role in the development of retinopathy after autologous peripheral blood stem cell transplantation. We suggested routine fundus examination of patients receiving autologous stem cell transplantation, combined chemotherapeutic regimen and/or radiation therapy. Keywords : Peripheral blood stem cell; transplantation; retinopathy