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Ocular manifestations of graft-versus-host disease: 10 years’ experience

PURPOSE: To evaluate the ocular presentation, treatment, and clinical course of graft-versus-host disease (GVHD). DESIGN: Retrospective case series. PARTICIPANTS: Two hundred and forty-nine patients with systemic GVHD were included in the study. METHODS: Ocular and systemic data were collected from...

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Autores principales: Lin, Xihui, Cavanagh, Harrison Dwight
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498717/
https://www.ncbi.nlm.nih.gov/pubmed/26170614
http://dx.doi.org/10.2147/OPTH.S84704
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author Lin, Xihui
Cavanagh, Harrison Dwight
author_facet Lin, Xihui
Cavanagh, Harrison Dwight
author_sort Lin, Xihui
collection PubMed
description PURPOSE: To evaluate the ocular presentation, treatment, and clinical course of graft-versus-host disease (GVHD). DESIGN: Retrospective case series. PARTICIPANTS: Two hundred and forty-nine patients with systemic GVHD were included in the study. METHODS: Ocular and systemic data were collected from 2003 to 2013. MAIN OUTCOME MEASURES: Mortality, visual acuity, and response of ocular symptoms. RESULTS: Sixty-four patients had ocular manifestations (25.7%). At presentation, the mean age was 44.5 years and mean latency was 16.4 months. The most common presentations were keratoconjunctivitis sicca, cataract, blepharitis, ocular hypertension, and filamentary keratitis. Visual acuity at presentation was 20/49; at the worst point in the disease was 20/115; and at most recent visit was 20/63. When topical anti-inflammatory drops were used in addition to tears, 54.3% of patients’ ocular symptoms stabilized. When autologous serum was used in addition, 80% stabilized. The overall 10-year mortality of GVHD was 29.7%. For those with ocular involvement, it was 21.9%. CONCLUSION: Systemic GVHD has a high mortality rate, but ocular involvement does not suggest a worse prognosis. The main ocular presentations were keratoconjunctivitis sicca, cataracts, and ocular hypertension. Dry eyes in this population were very severe with overall worsening in visual acuity. However, with a step-wise approach involving topical anti-inflammatory medications and autologous serum tears, ocular symptoms do improve. It is important to monitor these patients closely, as they are prone to serious ocular complications such as corneal perforation and endophthalmitis.
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spelling pubmed-44987172015-07-13 Ocular manifestations of graft-versus-host disease: 10 years’ experience Lin, Xihui Cavanagh, Harrison Dwight Clin Ophthalmol Original Research PURPOSE: To evaluate the ocular presentation, treatment, and clinical course of graft-versus-host disease (GVHD). DESIGN: Retrospective case series. PARTICIPANTS: Two hundred and forty-nine patients with systemic GVHD were included in the study. METHODS: Ocular and systemic data were collected from 2003 to 2013. MAIN OUTCOME MEASURES: Mortality, visual acuity, and response of ocular symptoms. RESULTS: Sixty-four patients had ocular manifestations (25.7%). At presentation, the mean age was 44.5 years and mean latency was 16.4 months. The most common presentations were keratoconjunctivitis sicca, cataract, blepharitis, ocular hypertension, and filamentary keratitis. Visual acuity at presentation was 20/49; at the worst point in the disease was 20/115; and at most recent visit was 20/63. When topical anti-inflammatory drops were used in addition to tears, 54.3% of patients’ ocular symptoms stabilized. When autologous serum was used in addition, 80% stabilized. The overall 10-year mortality of GVHD was 29.7%. For those with ocular involvement, it was 21.9%. CONCLUSION: Systemic GVHD has a high mortality rate, but ocular involvement does not suggest a worse prognosis. The main ocular presentations were keratoconjunctivitis sicca, cataracts, and ocular hypertension. Dry eyes in this population were very severe with overall worsening in visual acuity. However, with a step-wise approach involving topical anti-inflammatory medications and autologous serum tears, ocular symptoms do improve. It is important to monitor these patients closely, as they are prone to serious ocular complications such as corneal perforation and endophthalmitis. Dove Medical Press 2015-07-03 /pmc/articles/PMC4498717/ /pubmed/26170614 http://dx.doi.org/10.2147/OPTH.S84704 Text en © 2015 Lin and Cavanagh. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Lin, Xihui
Cavanagh, Harrison Dwight
Ocular manifestations of graft-versus-host disease: 10 years’ experience
title Ocular manifestations of graft-versus-host disease: 10 years’ experience
title_full Ocular manifestations of graft-versus-host disease: 10 years’ experience
title_fullStr Ocular manifestations of graft-versus-host disease: 10 years’ experience
title_full_unstemmed Ocular manifestations of graft-versus-host disease: 10 years’ experience
title_short Ocular manifestations of graft-versus-host disease: 10 years’ experience
title_sort ocular manifestations of graft-versus-host disease: 10 years’ experience
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498717/
https://www.ncbi.nlm.nih.gov/pubmed/26170614
http://dx.doi.org/10.2147/OPTH.S84704
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