title: Apoptosis in perforated cornea of a patient with graft-versus-host disease.
abstract: METHODS
  Although ocular complications associated with graft-versus-host disease (GVHD) can include corneal dysfunction, corneal perforation is not common. We report the presence of apoptotic cells in a perforated cornea of a patient with GVHD. A 72-year-old man with the angioimmunoblastic type of malignant lymphoma developed chronic GVHD after allogeneic peripheral blood stem cell transplantation. Despite systemic and topical treatment, both corneas perforated, and penetrating keratoplasty with cataract extraction and intraocular lens implantation was performed on both eyes.
  
  
  CONCLUSIONS
  The corneal button excised from the right eye was examined histologically and stained for apoptotic cells by TdT-mediated dUTP nick end labeling (TUNEL). This revealed thinning of the epithelial cell layer and stroma, with cells, including lymphocytes, infiltrating to the site of the perforation. Some of the epithelial cells and keratocytes were TUNEL positive. The presence of apoptotic cells in our case suggests that apoptosis may be involved in the perforation of the cornea in patients with GVHD.
authors.affiliation: Department of Opthalmology, Hamanomachi Hospital, Fukuoka, Japan. ayako@eye.med.kyushu-u.ac.jp
authors.forename: Ayako
authors.initials: A
authors.lastname: Yoshida
authors.forename: Yoh-Ichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Kouji
authors.initials: K
authors.lastname: Kato
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Muta
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gondo
authors.forename: Tsunefumi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yamana
mesh_terms: D000368:Aged; D017209:Apoptosis; D002387:Cataract Extraction; D002908:Chronic Disease; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology*; D003319:Corneal Stroma / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D005347:Fibroblasts / Q000473:pathology; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000628:therapy; D020287:In Situ Nick-End Labeling; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D012422:Rupture, Spontaneous