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Abstract: Ocular GVHD after allogeneic stem cell transplantation

Ocular Graft-Versus-Host Disease After Allogeneic Stem Cell Transplantation.
Cornea. 2010 May 20. [Epub ahead of print]
Westeneng AC, Hettinga Y, Lokhorst H, Verdonck L, van Dorp S, Rothova A.
From the *Departments of Ophthalmology; and daggerHematology, University Medical Center Utrecht, Utrecht, The Netherlands.

PURPOSE:: To determine the prevalence and manifestations of ocular graft-versus-host disease (GvHD) after allogeneic stem cell transplantation (allo-SCT).

METHODS:: Prospective study of 101 consecutive patients who received allo-SCT from 2004 to 2007. All patients received ophthalmologic examination for 3 months after allo-SCT, and those with ocular complaints were evaluated at 12 and 24 months thereafter. We registered ophthalmologic and hematological data, including the indication for allo-SCT, occurrence of systemic and ocular GvHDs, ocular manifestations, and various ocular treatments.

RESULTS:: Over time, ocular GvHD developed in 54% of patients and consisted mainly of dry eyes and conjunctivitis, which increased in severity during follow-up; blepharitis and uveitis were less often encountered. Acute systemic GvHD, especially the involvement of mouth and skin, was strongly associated with ocular GvHD at 3 months (P = 0.000). Chronic GvHD was associated with the occurrence of ocular GvHD (P = 0.000), especially with the development of the dry eye. Although eye symptoms affecting activities of daily living were reported in 24 of 54 patients (44%) and 16 of 54 patients (30%) experienced temporary loss of visual acuity of more than 2 Snellen lines, only 1 developed permanent unilateral loss (counting fingers) because of ischemic vasculopathy. Cataract development was not encountered, and only 1 eye developed intraocular infection.

CONCLUSION:: Ocular GvHD develops in a substantial part of patients after allo-SCT and decreases the activities of daily living.