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.
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