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Update on ocular graft versus host disease.
1The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. skim@mdanderson.org
Current Opinion in Ophthalmology
|August 11, 2006
Summary
Ocular graft versus host disease (GVHD) affects up to 80% of patients post-transplant. This review summarizes its clinical spectrum, pathophysiology, and treatment, emphasizing a multidisciplinary approach for ocular GVHD management.
Area of Science:
- Ophthalmology
- Hematology
- Immunology
Background:
- Ocular graft versus host disease (GVHD) is a frequent complication following allogeneic hematopoietic stem cell transplantation.
- It impacts up to 80% of patients with chronic GVHD, affecting all ocular structures.
Purpose of the Study:
- To review current findings on the clinical presentation, underlying mechanisms, and therapeutic strategies for ocular GVHD.
- To synthesize information relevant to ocular GVHD from recent National Institute of Health Chronic GVHD Consensus Workshops.
Main Methods:
- Literature review of recent findings on ocular GVHD.
- Summary of immunohistochemistry studies on lacrimal gland and conjunctival involvement.
- Delineation of diagnostic and treatment information from consensus workshops.
Main Results:
- Ocular GVHD presents with diverse clinical features affecting the entire eye, most commonly the ocular surface (conjunctiva, lacrimal gland).
- Symptoms include keratoconjunctivitis sicca, cicatricial conjunctivitis, and scleritis, mimicking other autoimmune conditions.
- Pathophysiology involves lacrimal gland dysfunction and conjunctival inflammation.
Conclusions:
- Ocular GVHD evaluation, diagnosis, and management require a multidisciplinary approach.
- Patient management must consider the overall GVHD status.
- Integrated care is crucial for optimizing outcomes in ocular GVHD.