Bilateral Ischemic Retinal Vasculopathy Following Haploidentical Hematopoietic Stem Cell Transplantation: A Case Report of Atypical Presentation in a Young Patient.

PURPOSE: To report a rare and challenging case of an atypical and bilateral ischemic retinal vasculopathy in a young patient following haploidentical bone marrow transplantation (BMT).

METHODS

Case report and literature review on ocular complications after hematopoietic stem cell transplantation (HSCT).

RESULTS

A 29-year-old woman presented with an atypical and bilateral ischemic retinal vasculopathy after haploidentical BMT, with a partial response to corticosteroids and anti-vascular endothelial growth factor therapy. Serial changes were documented using optical coherence tomography.

CONCLUSION

Ocular complications unrelated to graft-versus-host disease are generally uncommon after HSCT but can lead to significant and prolonged visual impairment. Retinal ischemic vasculopathy post-HSCT may present with typical and atypical features, each carrying distinct clinical manifestations and prognostic implications. While the typical form is well characterized in the literature, bilateral ischemic retinal vasculopathy following haploidentical HSCT remains unreported. Potential contributing factors include endothelial injury, microvascular occlusion, and immune-mediated mechanisms associated with HSCT. Moreover, medications used during and after transplantation-such as corticosteroids and immunosuppressants-may have ocular side effects that contribute to retinal complications. This case underscores the importance of early ophthalmologic evaluation in post-HSCT patients with visual symptoms, even in the absence of graft-versus-host disease.