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Ocular graft versus host disease: from keratoconjunctivitis sicca to ocular perforation – a four-case report

Poster Details

First Author: E.del Fresno SPAIN

Co Author(s):    J. Sambricio   R. Aburto   B. Sarmiento              

Abstract Details

Purpose:

To describe the ocular surface manifestations of graft versus host disease (GVHD) and to show the importance of proper management of ocular involvement.

Setting:

Hospital 12 de Octubre, Madrid (Spain)

Methods:

We have studied prospectively four patients with GVHD after allogeneic hematopoietic stem cell transplantation (HSCT) that presented ocular surface manifestations.

Results:

The first two cases have dry eye syndrome secondary to GVHD that is controlled with supplemental lubrication (artificial tears and cycles of autologous serum). Third case is a woman diagnosed with acute myeloid leukemia who was treated with allogeneic HSCT. She presented GVHD after withdrawal of immunosuppression. She suffered several corneal perforations despite treatment. Now, she has a low visual acuity due to corneal scarring, but her ocular surface remains stable with artificial tears. Forth case is a man diagnosed with diffuse large B-cell lymphoma. Allogeneic HSCT was performed and GVHD started one year later. Unilateral spontaneous corneal perforation occurred after cataract surgery. Actually, he is taking supplemental lubrication and presents a stable corneal thinning, without risk of perforation.

Conclusions:

Graft versus host disease is quite common after allogeneic stem cell transplantation and ocular involvement is present in most patients. Furthermore, ocular surface manifestations may be the first sign of the disease. We may find signs and symptoms of dry eye or serious ocular manifestations, like corneal recurrent ulcerations or corneal perforations. For that reason, it is very important to perform a proper management and monitoring of these patients.

Financial Disclosure:

NONE

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