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Clin Ophthalmol. 2013;7:2153-8. doi: 10.2147/OPTH.S51180. Epub 2013 Oct 31.

Bilateral corneal ulceration in ocular graft-versus-host disease.

Clinical ophthalmology (Auckland, N.Z.)

William Stevenson, Hasanain Shikari, Ujwala S Saboo, Francisco Amparo, Reza Dana

Affiliations

  1. Cornea Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

PMID: 24204119 PMCID: PMC3817064 DOI: 10.2147/OPTH.S51180

Abstract

PURPOSE: To report on corneal ulceration in ocular graft-versus-host disease (GVHD).

METHODS: This was a retrospective, observational case series investigating corneal ulceration and perforation in a cohort of ocular GVHD patients seen between June 2007 and October 2012.

RESULTS: Four of 243 ocular GVHD patients developed corneal ulcerations attributable to ocular GVHD, and all four cases involved bilateral corneal ulceration. The median length of time from the diagnosis of ocular GVHD to the diagnosis of the first corneal ulceration was 317 days (range 168-434). The median length of time between the diagnosis of corneal ulceration in each patient's first and second eye was 248 days (range 9-645). Outcomes varied from complete resolution with medical treatment to corneal perforation necessitating penetrating keratoplasty. In cases of corneal perforation, the median length of time from the diagnosis of corneal ulceration to perforation was 10 days (range 0-20). Common clinical features included: centrally or paracentrally located ulcerations and perforations, concomitant dry eye, and the use of topical or systemic corticosteroids.

CONCLUSION: Frequent follow-up and bilateral monitoring are highly recommended in cases of ocular GVHD-associated stromal thinning, as bilateral involvement or rapid progression to corneal perforation can occur.

Keywords: corneal perforation; corneal ulceration; graft-versus-host disease; ocular graft-versus-host disease

References

  1. Mol Vis. 2012;18:797-802 - PubMed
  2. Curr Opin Allergy Clin Immunol. 2012 Oct;12(5):540-7 - PubMed
  3. J Korean Med Sci. 2011 Jul;26(7):938-44 - PubMed
  4. Hematology Am Soc Hematol Educ Program. 2008;:134-41 - PubMed
  5. Invest Ophthalmol Vis Sci. 2007 Oct;48(10):4390; 4391-8 - PubMed
  6. Cornea. 2006 Jul;25(6):674-8 - PubMed
  7. Arch Ophthalmol. 1980 Jan;98(1):89-94 - PubMed
  8. Blood. 2001 Sep 15;98(6):1695-700 - PubMed
  9. JAMA Ophthalmol. 2013 Jun;131(6):715-723 - PubMed
  10. Int J Hematol. 2002 Apr;75(3):332-4 - PubMed
  11. Nat Rev Immunol. 2012 May 25;12(6):403-16 - PubMed
  12. N Engl J Med. 2006 Apr 27;354(17):1813-26 - PubMed
  13. Cornea. 2007 Jan;26(1):107-8 - PubMed
  14. Biol Blood Marrow Transplant. 2005 Dec;11(12):945-56 - PubMed
  15. Mol Vis. 2011 Feb 25;17:598-606 - PubMed
  16. Ocul Surf. 2005 Oct;3(4):203-11 - PubMed
  17. Zhonghua Yan Ke Za Zhi. 2003 Nov;39(11):686-90 - PubMed
  18. Am J Ophthalmol. 2005 Nov;140(5):920-1 - PubMed
  19. Ophthalmology. 1992 Jan;99(1):80-8 - PubMed
  20. Am J Pathol. 2009 Dec;175(6):2372-81 - PubMed
  21. Exp Eye Res. 2005 Sep;81(3):313-25 - PubMed
  22. Cornea. 2004 Aug;23(6):577-83 - PubMed
  23. Curr Opin Ophthalmol. 2006 Aug;17(4):344-8 - PubMed
  24. Bone Marrow Transplant. 2010 Jun;45(6):1077-83 - PubMed
  25. Bone Marrow Transplant. 2010 Aug;45(8):1340-6 - PubMed
  26. J Formos Med Assoc. 2006 Apr;105(4):334-9 - PubMed
  27. Cornea. 1995 Jan;14(1):97-102 - PubMed
  28. Nat Rev Immunol. 2012 May 11;12(6):443-58 - PubMed
  29. Cornea. 2010 Jul;29(7):758-63 - PubMed
  30. Can J Ophthalmol. 2006 Aug;41(4):472-5 - PubMed
  31. Eye (Lond). 2007 Jan;21(1):114-6 - PubMed
  32. Ophthalmology. 2000 Apr;107(4):631-9 - PubMed
  33. Cornea. 2012 Mar;31(3):299-310 - PubMed

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