Keeping an 'eye' on ocular GVHD

Area of Science:

• Ophthalmology
• Hematology
• Immunology

Background:

• Ocular graft-versus-host disease (GVHD) is a frequent complication following allogeneic haematopoietic stem cell transplantation (allo-HSCT).
• It affects a significant percentage of patients, particularly those with chronic GVHD, manifesting primarily as dry eye disease and ocular surface inflammation.
• Posterior segment involvement, though less common, can include retinopathy and scleritis.

Purpose of the Study:

• To review the clinical features, diagnostic criteria, and management strategies for ocular GVHD.
• To explore potential ophthalmic screening tools for early detection and intervention.
• To describe ocular GVHD in preclinical mouse models.

Main Methods:

• Literature review of clinical features, diagnostics, and treatments for ocular GVHD.
• Discussion of current and emerging screening methods, including corneal endothelial cell density and tear biomarker analysis.
• Summary of histopathological findings from preclinical mouse models.

Main Results:

• Ocular GVHD presents with diverse symptoms, predominantly dry eye, impacting quality of life.
• Early and consistent ocular assessment, including pre-transplant screening, is crucial for timely intervention.
• Advanced screening techniques show promise for improved detection.

Conclusions:

• Regular ocular assessments and novel screening tools are vital for managing ocular GVHD post-allo-HSCT.
• Early detection and intervention can prevent severe visual impairment and improve patient well-being.
• Preclinical models offer insights into the pathogenesis and potential therapeutic targets.