Ocular complications after liver transplantation: A comprehensive review of infectious and non-infectious etiologies

Table 1 Summary of infectious ocular complications post-liver transplant

Infection type	Pathogen(s)	Typical clinical features	Diagnostic method	Treatment
CMV retinitis	Cytomegalovirus	Retinal hemorrhage, necrosis	Fundoscopy, PCR	Valganciclovir, ganciclovir
Herpetic keratitis	HSV-1, HSV-2	Dendritic corneal ulcer	Slit-lamp, PCR	Acyclovir, foscarnet
Herpes zoster ophthalmicus	Varicella zoster virus	Pseudodendritic, periocular pustular skin eruption	Slit-lamp, PCR	Acyclovir, famciclovir, valacyclovir
Candida endophthalmitis, Candida retinitis	Candida spp.	Endophthalmitis Retinitis: Creamy raised retinal lesions	Slit-lamp, Fundus exam, PCR	Fluconazole, voriconazole, intravitreal amphotericin B
Aspergillus endophthalmitis	Aspergillus species, Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus	Corneal ulcer, satellite lesions, fluffy white-pre-retinal lesions	Fundoscopy	Voriconazole, amphotericin B
Rhino-orbital cerebral zygomycosis	Rhizopus, Mucor, Absidia	Diplopia, Ptosis, ophthalmoplegia, decreased visual acuity, blindness	MRI/CT, PCR	Amphotericin B, debridement

CMV: Cytomegalovirus retinitis; PCR: Polymerase Chain Reaction; HSV: Herpes simplex virus; MRI: Magnetic resonance imaging; CT: Computed tomography.

Table 2 Summary of non-infectious ocular complications post liver transplant

Disease	Pathogenesis	Clinical manifestation	Treatment
Dry eye disease	Apoptosis of the lacrimal gland due to inflammation	Gritty sensation, visual disruption	Artificial tears
Cataract	Oxidative stress	Glare, diminution of visual acuity	Surgery
Central retinal vein occlusion	Hyperlipidemia, Neurotoxicity	Sudden vision loss	Anti-VEGF, intravitreous dexamethasone implants
Ocular PTLD	B cell overgrowth due to T-cell suppression	Uveitis and subretinal mass	Rituximab, antiviral agents

VEGF: Vascular endothelial growth factor; PTLD: Post-transplant lymphoproliferative disorder.