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Posterior segment complications of graft versus host disease after bone marrow transplantation
  1. N G Strouthidis1,2,
  2. P J Francis1,2,
  3. M R Stanford1,
  4. E M Graham1,
  5. G E Holder2,
  6. A C Bird2
  1. 1The Medical Eye Unit, 9th Floor, North Wing, St Thomas’s Hospital, Lambeth Palace Road, London SE1 7EH, UK
  2. 2Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK
  1. Correspondence to: Dr E M Graham The Medical Eye Unit, 9th Floor, North Wing, St Thomas’s Hospital, Lambeth Palace Road, London SE1 7EH, UK; nicholas.strouthidisbtinternet.com

https://doi.org/10.1136/bjo.87.11.1421-a

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    The efficacy of bone marrow transplantation (BMT) for the treatment of selected diseases of the haemopoietic system such as chronic myeloid leukaemia (CML) is well recognised. Graft versus host disease (GVHD) is however a common and potentially life threatening complication of this treatment, occurring in up to 75% of cases. It is thought to arise when immunocompetent donor T lymphocytes mount an immune response against host tissues. GVHD is characterised by a triad of enteritis, dermatitis, and hepatitis, but almost all organs may be targeted. Ocular involvement is frequently seen but is usually limited to the anterior segment. Posterior segment manifestations are rare.

    This report describes two cases of GVHD with unusual posterior segment involvement that highlight the diversity of presentations in this condition.

    Case 1

    A 45 year old white male presented with progressive bilateral blurred vision and floaters 10 months post-BMT for CML. He had no history of ocular disease. His symptoms started 10 days after discontinuation of cyclosporin A as a routine protocol and were accompanied by alopecia, poliosis, vitiligo, and oral mucositis. A presumptive diagnosis of acute GVHD was made and cyclosporin restarted together with prednisolone. His other medications were azathioprine, aciclovir, fluconazole, …

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