The ocular graft-versus-host disease: the path from current knowledge to future managements

Area of Science:

• Ophthalmology
• Hematology
• Immunology

Background:

• Graft-versus-host disease (GVHD) is a significant complication following allogeneic hematopoietic stem cell transplantation (HSCT).
• Ocular GVHD (oGVHD) presents diversely, affecting ocular structures like the cornea, lacrimal gland, conjunctiva, eyelid, and nasolacrimal duct.
• Understanding oGVHD is crucial for managing HSCT recipients.

Purpose of the Study:

• To review and summarize current management strategies for ocular GVHD (oGVHD).
• To highlight emerging therapeutic advances in oGVHD treatment.
• To provide clinicians with an update on novel treatment options for oGVHD.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Web of Science, and Google Scholar.
• Relevant studies published within the last 20 years were included.
• Keywords focused on GVHD, ocular manifestations, dry eye, and keratitis.

Main Results:

• Current oGVHD management includes topical immunosuppressants, tear-preservatory treatments, local non-pharmacological/surgical interventions, and systemic therapies.
• Innovative therapies such as topical targeted treatments, epitheliotrophic/neurotrophic therapies, recombinant DNase eye drops, and mesenchymal stromal cell injections show promise.
• These advanced treatments offer potential for improved clinical outcomes in oGVHD.

Conclusions:

• oGVHD management follows a symptom-based, stepwise approach.
• Advances in innovative therapies are vital for enhancing clinical outcomes.
• Physicians must remain informed about novel treatment options for oGVHD.