TY - JOUR T1 - In vivo confocal microscopic characterisation of the cornea in chronic graft-versus-host disease related severe dry eye disease JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 160 LP - 165 DO - 10.1136/bjophthalmol-2014-305072 VL - 99 IS - 2 AU - B Steger AU - L Speicher AU - W Philipp AU - N E Bechrakis Y1 - 2015/02/01 UR - http://bjo.bmj.com/content/99/2/160.abstract N2 - Aims To first describe in vivo confocal microscopic (IVCM) corneal findings in severe dry eye syndrome due to ocular chronic graft versus host disease (cGvHD) after allogeneic stem cell transplantation. Methods IVCM of the central cornea was performed in 12 prospectively recruited patients with severe ocular cGvHD associated dry eye syndrome and in six control patients with haematological malignancies without cGvHD. Within each examined corneal layer, at least three non-overlapping areas were selected for representative analysis. Results The number of sub basal nerve branches was markedly reduced in patients with cGvHD. Sub basal nerve morphology was characterised by increased tortuosity and reduced reflectivity. Accumulation of hyper-reflective extracellular matrix, significantly increased haze and increased keratocyte density were found in the anterior stroma of the study group. Conclusions IVCM findings of the cornea in patients with severe ocular cGvHD include a rarefaction of the sub basal corneal nerve plexus and dense accumulation of hyper-reflective extracellular matrix in the anterior stroma. ER -