CASE OF BILATERAL CHOROIDAL DETACHMENTS IN GRAFT-VERSUS-HOST DISEASE AND HYPOALBUMINAEMIA AFTER REDUCED-INTENSITY ALLOGENEIC BONE MARROW STEM CELL TRANSPLANTATION.

PURPOSE: To report a case of bilateral choroidal detachments in a patient with myelodysplasia who developed graft-versus-host disease and hypoalbuminemia after allogeneic bone marrow transplantation.

METHODS

Case report imaged with ultra-widefield color photographs and B-scans.

RESULTS

The patient presented with a 3-day history of bilateral visual deterioration, associated with right eye floaters. Fundus examination revealed choroidal detachments in all four quadrants associated with serous retinal detachment in the right eye and in the inferotemporal and inferonasal quadrant of the left eye. Medical history included allogeneic bone marrow transplantation for myelodysplastic syndrome seven months prior and development of symptoms of graft-versus-host disease three weeks prior. His serum albumin and protein levels were severely low. The detachments subsequently resolved with treatment of the hypoalbuminemia and low protein.

CONCLUSION

Choroidal detachment is a possible complication of hypoalbuminemia and graft-versus-host disease. Hypoalbuminemia causing a reduction in the gradient for transscleral diffusion of albumin or graft-versus-host disease-related immune reaction is a possible mechanism of this complication.