Michelle Hessen1, Esen K Akpek. 1. Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Abstract
PURPOSE OF REVIEW: This review was carried out to study the frequency, and severity of ocular surface involvement at the setting of allogeneic hematopoietic stem cell transplantation and subsequent graft-versus-host disease (GVHD) and evaluate the clinical outcomes of newer treatments. RECENT FINDINGS: Ocular involvement has been reported in 60-90% of patients with chronic GVHD. Although dry eye is the most frequent finding occurring in the great majority of patients (up to 90%), posterior segment complications are also not infrequent, seen in 12.8% of patients after bone marrow transplantation. Anti-inflammatory treatments particularly T-cell suppressants seem to have a beneficial effect in managing GVHD. Corticoteroids, calcineurin inhibitors, such as cyclosporine and tacrolimus, as well as antifibrotic agents such as tranilast are available options for topical application. Cyclosporine ophthalmic drop seems to be a well tolerated and effective treatment modality; favorable results have been demonstrated with increased dosage. SUMMARY: GVHD is an increasingly frequent cause of ocular surface morbidity with the potential of visual loss from corneal involvement. Early diagnosis and aggressive local as well as systemic treatment can be vision saving.
PURPOSE OF REVIEW: This review was carried out to study the frequency, and severity of ocular surface involvement at the setting of allogeneic hematopoietic stem cell transplantation and subsequent graft-versus-host disease (GVHD) and evaluate the clinical outcomes of newer treatments. RECENT FINDINGS: Ocular involvement has been reported in 60-90% of patients with chronic GVHD. Although dry eye is the most frequent finding occurring in the great majority of patients (up to 90%), posterior segment complications are also not infrequent, seen in 12.8% of patients after bone marrow transplantation. Anti-inflammatory treatments particularly T-cell suppressants seem to have a beneficial effect in managing GVHD. Corticoteroids, calcineurin inhibitors, such as cyclosporine and tacrolimus, as well as antifibrotic agents such as tranilast are available options for topical application. Cyclosporine ophthalmic drop seems to be a well tolerated and effective treatment modality; favorable results have been demonstrated with increased dosage. SUMMARY:GVHD is an increasingly frequent cause of ocular surface morbidity with the potential of visual loss from corneal involvement. Early diagnosis and aggressive local as well as systemic treatment can be vision saving.
Authors: Jennifer L Lockridge; Ying Zhou; Yusof A Becker; Shidong Ma; Shannon C Kenney; Peiman Hematti; Christian M Capitini; William J Burlingham; Annette Gendron-Fitzpatrick; Jenny E Gumperz Journal: Biol Blood Marrow Transplant Date: 2013-06-24 Impact factor: 5.742
Authors: Tulio B Abud; Francisco Amparo; Ujwala S Saboo; Antonio Di Zazzo; Thomas H Dohlman; Joseph B Ciolino; Pedram Hamrah; Reza Dana Journal: Ophthalmology Date: 2016-04-13 Impact factor: 12.079
Authors: G Giannaccare; F Bonifazi; M Sessa; E Dan; M Arpinati; M Fresina; G Bandini; M Cavo; P Versura; E C Campos Journal: Eye (Lond) Date: 2017-05-19 Impact factor: 3.775
Authors: Samantha Herretes; Duncan B Ross; Stephanie Duffort; Henry Barreras; Tan Yaohong; Ali M Saeed; Juan C Murillo; Krishna V Komanduri; Robert B Levy; Victor L Perez Journal: Invest Ophthalmol Vis Sci Date: 2015-04 Impact factor: 4.799
Authors: Robert G Newman; Duncan B Ross; Henry Barreras; Samantha Herretes; Eckhard R Podack; Krishna V Komanduri; Victor L Perez; Robert B Levy Journal: Immunol Res Date: 2013-12 Impact factor: 2.829