Chronic Ocular Graft vs Host Disease as a Serious Complication of Allogeneic Hematopoietic Stem Cell Transplantation: Case Report
Related Experiment Video
Updated: Apr 11, 2026
Induction of Graft-versus-host Disease and In Vivo T Cell Monitoring Using an MHC-matched Murine Model
Published on: August 29, 2012
I Gama1, W Rodrigues1, J Franco1
1Ophthalmology Department, Hospital Santa Maria (Centro Hospitalar Lisboa Norte), Lisbon, Portugal; Faculty of Medicine of Lisbon, University of Lisbon, Lisbon, Portugal.
Insights
Chronic graft-versus-host disease (GVHD) can cause severe eye complications, including corneal ulcers and perforation, even with treatment. Close ophthalmological monitoring is crucial after stem cell transplants to manage these risks.
Area of Science:
- Immunology
- Ophthalmology
- Transplantation
Background:
- Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can lead to chronic graft-versus-host disease (cGVHD), a systemic immunological complication.
- Ocular GVHD (O-GVHD) frequently co-occurs with cGVHD, potentially causing secondary corneal epithelial changes.
Observation:
- Advanced chronic O-GVHD-associated keratoconjunctivitis sicca (KCS) typically has a stable course with medical treatment.
- However, severe manifestations like bilateral corneal ulcers and ocular perforation can occur in extreme cases.
Findings:
- This report details two cases of severe ocular complications in advanced chronic O-GVHD.
- One case presented with ocular perforation, and the other with bilateral simultaneous corneal ulcers, occurring despite treatment.
Implications:
- These cases highlight rare but serious potential outcomes of chronic O-GVHD.
- Emphasizes the critical need for vigilant ophthalmological surveillance and multidisciplinary communication post-allo-HSCT.
Abstract:
Chronic graft-vs-host disease (cGVHD) is a serious systemic immunological complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Ocular GVHD (O-GVHD) is frequently associated with cGVHD. Secondary corneal epithelial changes can occur in the setting of advanced chronic O-GVHD-associated keratoconjunctivitis sicca (KCS), which generally has a stable course with conventional medical treatment. Bilateral corneal ulcers and ocular perforation, although not frequent, can occur in most extreme cases. The authors describe 2 clinical cases of ocular perforation (Clinical case 1) and bilateral simultaneous corneal ulcers (Clinical case 2) due to advanced chronic O-GVHD, which can rarely occur despite treatment. A close ophthalmological follow-up and good dialogue with the multidisciplinary transplantation team are essential after allo-HSCT.
