Vision screening unnecessary for asymptomatic post-transplant patients, study finds

Routine vision screening may not be necessary for heart and lung transplant patients receiving high-dose immunosuppression, according to a study by researchers in London.

Susan Lightman, PhD, FRCOphth, of Moorfields Eye Hospital, and colleague Toks Akerele, MBChB, examined ocular morbidity rates in 115 patients on long-term, high-dose immunosuppression for maintaining their heart, lung, or heart and lung transplants. They published their findings in the March issue of the British Journal of Ophthalmology.

Overall, investigators found ocular disease in 62 patients (54%). Cataracts were most common and seen in 17%, followed by hypertensive change in 8%, chorioretinal scarring in 5% and diabetic retinopathy in 3%. Of these patients, 18 (16%) were symptomatic upon examination, with blurred vision being the most common complaint. Among patients with cataract, about 25% had posterior subcapsular lens opacity due to steroid therapy, according to the study.

One patient developed ocular infective complications after surgery for Aspergillus spp. endophthalmitis, the authors said.

"Patients had surprisingly low incidences of ocular infective complications, despite previous reports. It is likely that this is due to improved immunosuppression regimes and improved monitoring of immunosuppression in the early post-transplant period," the authors said. "The screening of asymptomatic individuals following heart, lung or heart-lung transplantation was not supported by this study."