The Dry Eye Zone

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Abstract: GvHD and the eyes


I hope that the "possible strategies" for ocular GvHD discussed in the full article had the BOSP at the top of the list. I think it is unconscionable to fail to educate GvHD patients on the potential of this treatment, given how serious the complications can be for the eyes when other treatments fail.

Ocular Involvement in Chronic Graft-Versus-Host Disease: Therapeutic Approaches to Complicated Courses.
Cornea. 2010 Sep 15. [Epub ahead of print]
Koch KR, Joussen AM, Huber KK.
From the Department of Ophthalmology, University of Duesseldorf, Duesseldorf, Germany.

Chronic graft-versus-host disease (cGvHD) is a major concomitant phenomenon in recipients of allogeneic hematopoietic stem cell transplantations, affecting multiple organ systems including the eye. Ocular structures, such as lacrimal gland, conjunctiva, and eyelids with meibomian glands, are frequently involved with clinical features ranging from dry eyes and common inflammatory conjunctival disease to severe complications like corneal ulcerations or even perforations. We present 2 patients with complicated courses of ocular cGvHD. In both cases, keratoconjunctivitis sicca refractory to systemic immunosuppressive therapy and to conventional topical treatment resulted in progressive binocular corneal melting and finally repeated perforations. According to our 2 cases and to the current pathophysiological understanding, we discuss possible strategies for the treatment and prevention of ocular cGvHD complications.
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