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II. Histopathology

Douglas A. Jabs, MD; Lawrence W. Hirst, MD; W. Richard Green, MD; Peter J. Tutschka, MD; George W. Santos, MD; William E. Beschorner, MD

Arch Ophthalmol. 1983;101(4):585-590.

Abstract
• The major histopathologic changes seen in the eyes of patients undergoing bone marrow transplantation involve the conjunctiva, cornea, choroid, and lacrimal gland. The major finding in the conjunctiva is keratinization. The major findings in the cornea are epithelial thinning and keratinization. Keratinization of the conjunctiva and cornea is associated with graft-v-host disease (GVHD) and may be either a primary manifestation of GVHD or be secondary to the "dry eye" syndrome that develops in patients with GVHD. Corneal epithelial thinning is probably secondary to the chemotherapy used in the preparative regimen. An unusual histiocytelike infiltrate is present in the choroid and appears to be associated with GVHD. In acute GVHD, lacrimal gland stasis occurs and is the probable cause of the dry eyes seen in these patients.

Author Affiliations
From the Wilmer Ophthalmological Institute (Drs Jabs, Hirst, and Green), the Department of Pathology (Drs Green and Beschorner), and the Bone Marrow Transplant Unit, Oncology Center (Drs Tutschka, Santos, and Beschorner), Johns Hopkins Medical Institutions, Baltimore. Dr Hirst is now with Bethesda Eye Institute, St Louis.

Footnotes
Accepted for publication May 3, 1982.

Read in part before the meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Fla, April 27, 1981.

Reprint requests to Bethesda Eye Institute, 3655 Vista Ave, St Louis, MO 63110 (Dr Hirst).

This investigation was supported in part by Public Health Service research grants EY 02476 (Dr Hirst) and EY 01684 (Dr Green), EM core grant EY 01765, computer core grant 2 P30 EY 01765, and grant CA 15396 from the National Cancer Institute.

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