Comparison among different diagnostic criteria for chronic ocular graft-versus-host disease applied with and without pre-transplant ophthalmological examination

Giannaccare, Giuseppe; Versura, Piera; Bonifazi, Francesca; Sessa, Mariarosaria; Campos, Emilio C.

doi:10.1038/s41433-018-0210-4

Cited by 13 publications

(10 citation statements)

References 24 publications

(40 reference statements)

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“…An extension of the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) criteria originally meant for conventional DED has been recently advocated for diagnosing oGVHD in patients undergoing allo-HSCT[ 26 ] according to which any new positivity or worsening of the existing disease after allo-HSCT may be considered to be sufficient for diagnosing oGVHD. Diagnosis required ocular surface discomfort symptoms with OSDI score ≥13 along with any one of the following; TFBUT <10 s; tear osmolarity >308 mOsm/L in either eye (or an inter-eye difference >8 mOsm/L); ocular surface staining (>5 corneal spots, >9 conjunctival spots or lid wiper epitheliopathy of ≥2 mm in length and/or ≥25% sagittal width).…”

Section: Current Perspectives On Ogvhd Diagnostic Criteria Definition and Gradingmentioning

confidence: 99%

“…The influence of a pre-allo-HSCT evaluation on diagnostic performance seems to be much more for NIH and ICCGVHD criteria emphasizing that majority of pre-allo-HSCT DED cases were due to tear film instability. [ 26 ] Pre-allo-HSCT evaluation for DED is now widely recommended to help differentiate between preexisting dry eye and the new-onset DED diagnosed as oGVHD post-allo-HSCT.…”

Section: Current Perspectives On Ogvhd Diagnostic Criteria Definition and Gradingmentioning

confidence: 99%

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Update on ocular graft-versus-host disease

Nair

Vanathi

Mukhija

et al. 2021

Indian Journal of Ophthalmology

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Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.

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Section: Current Perspectives On Ogvhd Diagnostic Criteria Definition and Gradingmentioning

confidence: 99%

Section: Current Perspectives On Ogvhd Diagnostic Criteria Definition and Gradingmentioning

confidence: 99%

Update on ocular graft-versus-host disease

Nair

Vanathi

Mukhija

et al. 2021

Indian Journal of Ophthalmology

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“…Giannaccare, et al showed that dry eye is already present in a large percentage of patients with hematologic disease before HCT. 80 Early diagnosis is key to control of symptoms and ultimately managing the clinical signs. Recent research is focused on advancements in prophylaxis, diagnostic criteria, and treatment.…”

Section: Overview Of Chronic Ogvhdmentioning

confidence: 99%

“…This approach allows for better coordination between care team providers. 17,[115][116][117][118] Anecdotally, artificial lubricants and 0.05% cyclosporine-A (CsA) are usually the treatment of the first choice for hematologists/oncologists. A longitudinal, prospective, non-randomized small study of 20 transplant patients was pre-treated with CsA twice daily for 12 months after transplant.…”

Section: Management Of Chronic Ogvhdmentioning

confidence: 99%

Chronic Ocular Graft Versus Host Disease: An Update and Review

Groth

Conto

Pasquini

2020

JDED

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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.

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“…Tear biomarkers in oGVHD have focused mainly on the role of cytokines [8,10,[14][15][16][17] and less on protein profiling to find candidate proteins that can be associated with the disease [18,19]. All these previous studies have been performed on post-HSCT patients, whereas ocular surface changes and high DED prevalence were shown already before HSCT [20,21]. This had suggested that a pre-HSCT ocular surface assessment is recommended for early DE management and appropriate evaluation of post-HSCT changes [6].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Tear Protein Changes Correlate with Ocular Chronic GVHD Development in Allogeneic Hematopoietic Stem Cell Transplant Patients

et al. 2021

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Ocular graft-versus-host disease (oGVHD) is a manifestation of chronic GVHD, frequently occurring in patients after allogeneic hematopoietic stem cell transplant (HSCT). We analyzed tear protein changes before and after allogeneic HSCT, and correlated their levels with the oGVHD development. This retrospective study included 102 patients, and data were recorded before the conditioning treatment, and after 3 to 6 months postoperatively. Tear protein analysis was performed with the Agilent-2100 Bioanalyzer on individual tears sampled by aspiration. Total protein (TP), Lysozyme-C (LYS-C), Lactoferrin (LACTO), Lipocalin-1 (LIPOC-1), Transferrin (TRANSF), Albumin (ALB), and Zinc-alpha-2-glycoprotein (ZAG-2) levels were retrieved and statistically analyzed. Following HSCT forty-three patients developed oGVHD. TP, LACTO, LYS-C, and ZAG-2 levels significantly decreased post-HSCT as compared to pre HSCT levels. In univariate analysis, TP, LACTO, and ZAG-2 decrease was associated with an increased development of oGVHD (OR = 4.49; 95% CI, 1.9 to 10.5; p < 0.001; OR = 3.08; 95% CI 1.3 to 7.6; p = 0.01; OR = 11.1; 95% CI 2.7 to 46.6; p < 0.001, respectively). TRANSF post-HSCT levels significantly increased (OR 15.7; 95% CI, 4.1 to 52.2; p = 0.0001). No pre-post-HSCT changes were shown in ALB and LIPOC-1 levels. Data suggest that TP content, LACTO, TRANSF, and ZAG-2 pre-post changes might be significant predictors of oGVHD development.

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Comparison among different diagnostic criteria for chronic ocular graft-versus-host disease applied with and without pre-transplant ophthalmological examination

Abstract: The diagnosis of ocular GVHD varied significantly in our cohort of hematological patients according to both the diagnostic criteria used and the visit protocols applied.

Cited by 13 publications

References 24 publications

Update on ocular graft-versus-host disease

Update on ocular graft-versus-host disease

Chronic Ocular Graft Versus Host Disease: An Update and Review

Longitudinal Tear Protein Changes Correlate with Ocular Chronic GVHD Development in Allogeneic Hematopoietic Stem Cell Transplant Patients

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