{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:32:31Z","timestamp":1792211551392,"version":"4.4.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Corneal perforation is a rare and serious complication of ocular graft-versus-host disease (oGVHD) patients. This study was to retrospectively report seven corneal perforation patients after allogeneic hematopoietic stem cell transplantation (HSCT). Demographic, hematologic, and ophthalmological data of patients were clarified in detail. Nine eyes of seven corneal perforation patients were clarified (Cases 3 and 6 were bilateral and the others are unilateral). All the cases had other affected GVHD organs, especially skin involvement. The duration between HSCT and corneal perforation was usually long with 21 (17\u2013145) months as median interval, whereas the duration between oGVHD diagnosis and corneal perforation was relatively shorter with 4 (2\u201381) months as median interval. Most patients presented to ophthalmology department with poor visual acuity, BUT and Schirmer\u2019s test. Eyelid marginal hyperemia and irregularity were observed in most corneal perforation eyes. Keratoplasty or conjunctival flap covering (CFC) surgeries was performed after corneal perforation. After a long-term follow-up for most patients (median 21 months, range: 2\u201386 months), only two eyes of two patients (22.22%) had a final BCVA of 20\/100 or better. Patients involved in both cutaneous GVHD and blepharitis indicate the aggressive development of oGVHD. Early diagnosis, long-term follow-up, and effective multi-disciplinary treatments for oGVHD patients are essential. Corticosteroids and immunosuppressor remain essential, whereas the use of topical corticosteroids should be carefully considered in corneal ulceration patients. In addition, appropriate surgeries should be performed to control oGVHD development in time.<\/jats:p>","DOI":"10.3389\/fonc.2022.962250","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T11:40:46Z","timestamp":1663242046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Corneal perforation associated with ocular graft-versus-host disease"],"prefix":"10.3389","volume":"12","author":[{"given":"Yue","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Ming","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Tai","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Long","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Yu","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Ru","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Wen","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Feng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000001071","article-title":"A review of ocular graft-versus-host disease","volume":"94","author":"Munir","year":"2017","journal-title":"Optom Vis Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s11864-021-00850-3","article-title":"Cardiovascular issues in hematopoietic stem cell transplantation (HSCT)","volume":"22","author":"L\u00f3pez-Fern\u00e1ndez","year":"2021","journal-title":"Curr Treat Options Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00079","article-title":"Pathophysiology of GvHD and other HSCT-related major complications","volume":"8","author":"Ghimire","year":"2017","journal-title":"Front Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.ajo.2021.02.022","article-title":"Incidence, risk factors and complications of ocular graft-Versus-Host disease following hematopoietic stem cell transplantation","volume":"227","author":"Pellegrini","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-019-04301-6","article-title":"Ocular surface system alterations in ocular graft-versus-host disease: all the pieces of the complex puzzle","volume":"257","author":"Giannaccare","year":"2019","journal-title":"Graefe\u2019s Arch Clin Exp Ophthalmol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22116114","article-title":"Cascade of inflammatory, fibrotic processes, and stress-induced senescence in chronic gvhd-related dry eye disease","volume":"22","author":"Ogawa","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/08164622.2021.1971047","article-title":"Keeping an \u2018eye\u2019 on ocular GVHD","volume":"105","author":"Kezic","year":"2021","journal-title":"Clin Exp Optom"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S51180","article-title":"Bilateral corneal ulceration in ocular graft-versus-host disease","volume":"7","author":"Stevenson","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-Host disease: I. the 2014 diagnosis and staging working group report","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2015.03.038","article-title":"Chronic ocular graft vs host disease as a serious complication of allogeneic hematopoietic stem cell transplantation: Case report","volume":"47","author":"Gama","year":"2015","journal-title":"Transplant Proc"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2021.03.033","article-title":"National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-Host disease: IIa. the 2020 clinical implementation and early diagnosis working group report","volume":"27","author":"Kitko","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002659","article-title":"Risk factors for ocular involvement in pediatric graft-Versus-Host disease","volume":"40","author":"H\u00e9bert","year":"2021","journal-title":"Cornea"},{"key":"B13","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s40257-017-0306-9","article-title":"Cutaneous graft-Versus-Host disease: Diagnosis and treatment","volume":"19","author":"Strong Rodrigues","year":"2018","journal-title":"Am J Clin Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.17-23750","article-title":"Sj\u00f6gren\u2019s syndrome, non-sj\u00f6gren\u2019s syndrome, and graft-versus-host disease related dry eye","volume":"59","author":"Ogawa","year":"2018","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S84704","article-title":"Ocular manifestations of graft-versus-host disease: 10 years\u2019 experience","volume":"9","author":"Lin","year":"2015","journal-title":"Clin Ophthalmol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2021.101224","article-title":"Corneal perforation in ocular graft-versus-host disease","volume":"24","author":"Zhang","year":"2021","journal-title":"Am J Ophthalmol Case Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-013-2301-z","article-title":"Graft versus host disease: Clinical evaluation, diagnosis and management","volume":"251","author":"Espana","year":"2013","journal-title":"Graefe\u2019s Arch Clin Exp Ophthalmol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1186\/s12886-016-0339-5","article-title":"The effects of oral and topical corticosteroid in rabbit corneas","volume":"16","author":"Araki-Sasaki","year":"2016","journal-title":"BMC Ophthalmol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.ajo.2020.05.035","article-title":"Prevalence of persistent corneal epithelial defects in chronic ocular graft-Versus-Host disease","volume":"218","author":"Sinha","year":"2020","journal-title":"Am J Ophthalmol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9580292","article-title":"Total penetrating keratoplasty: Indications, therapeutic approach, and long-term follow-up","volume":"2018","author":"Krysik","year":"2018","journal-title":"J Ophthalmol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"100768","DOI":"10.1016\/j.preteyeres.2019.07.001","article-title":"Immune reactions after modern lamellar (DALK, DSAEK, DMEK) versus conventional penetrating corneal transplantation","volume":"73","author":"Hos","year":"2019","journal-title":"Prog Retin Eye Res"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.962250\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T11:41:00Z","timestamp":1663242060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.962250\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,15]]},"references-count":21,"alternative-id":["10.3389\/fonc.2022.962250"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.962250","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,15]]},"article-number":"962250"}}