The Eye in Bone Marrow Transplantation: II. Histopathology

• 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.