Chronic Ocular Graft Versus Host Disease: An Update and Review

Abstract

An updated comprehensive literature review was completed of chronic ocular graft versus host disease (oGVHD) to identify current and future considerations as to the causes, diagnosis, and treatment of this complication after allogenic hematopoietic cell transplantation (HCT). Graft-versus-host disease involves multiple organ systems, including the eye, and is a leading cause of mortality and morbidity in these patients. This review consisted a comprehensive search of the PubMed, ClinicalTrials.gov and NIH.gov databases.
 oGVHD is a debilitating and potentially sight threatening condition. Commonly involved ocular structures include the cornea, conjunctiva, meibomian glands, eyelids, lacrimal gland and tear film. Identifying and treating the ocular complications at the early stages may improve final outcomes and quality of life in these patients. Aggressive lubrication, preservation of tear film and inflammation control, including minimizing surface scarring, are treatment goals. Co-management with HCT and other pertinent health care providers is critical for early diagnosis and to initiate prompt therapy to minimize the ocular damage. Stepped therapy, including the use of emerging systemic treatments can be useful in the management of oGVHD with stable visual function, quality of life and complication management as goals of treatment.