Meibomian Gland Dysfunction: A Route of Ocular Graft-Versus-Host Disease Progression That Drives a Vicious Cycle of Ocular Surface Inflammatory Damage

Pérez, Víctor L.; Mousa, Hazem M.; Soifer, Matias; Beatty, Cole; Sarantopoulos, Stefanie; Saban, Daniel R.; Levy, Robert B.

doi:10.1016/j.ajo.2022.09.009

Cited by 12 publications

(17 citation statements)

References 62 publications

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“…1 a , 1 b ), pseudo-membrane formation, distichiasis, trichiasis, subtarsal fibrosis ( Fig. 1 b ) right up to a scar entropion 10 , 11 , 12 , 13 . In the context of keratoconjunctivitis sicca – and particularly inflammation of the ocular surface caused by activated T cells and dendritic cells – chemosis and lid-parallel conjunctival folds (LIPCOF) are also often found 13 , 14 .…”

Section: Clinical Findingsmentioning

confidence: 98%

“…1 a , 1 b ), Pseudomembranen, Distichiasis, Trichiasis, subtarsaler Fibrosierung ( Abb. 1 b ) bis hin zu einem Narbenentropium kommen 10 11 12 13 . Im Rahmen der Keratoconjunctivitis sicca – und insbesondere der Entzündung der Augenoberfläche durch aktivierte T-Zellen und dendritische Zellen – finden sich oft auch eine Chemose und lidkantenparallele konjunktivale Falten (LIPCOF) 13 , 14 .…”

Section: Klinische Befundeunclassified

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Augenbeteiligung bei Graft-versus-Host-Erkrankung

Tappeiner,

Heiligenhaus,

Dietrich-Ntoukas

2024

Klin Monbl Augenheilkd

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ZusammenfassungIm Rahmen der okulären Graft-versus-Host-Erkrankung (GVHD) kommt es nach allogener hämatopoetischer Zelltransplantation zu einer Entzündungsreaktion an der Augenoberfläche. Verantwortlich hierfür sind insbesondere selbstreaktive T-Zellen des Spenders. Dies kann u. a. zu einer ausgeprägten Keratoconjunctivitis sicca, Bindehauthyperämie, Hornhautulzerationen und -einschmelzung bis hin zur Perforation führen. Die okuläre GVHD geht mit einem hohen Leidensdruck wie Schmerzen, Photophobie und Visusminderung einher. Diese Übersichtsarbeit gibt einen Überblick über typische ophthalmologische Befunde, topische und systemische Therapieansätze, begleitende Maßnahmen (z. B. Sklerallinsen, Punctum plugs) und das entsprechende Management von Komplikationen.

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Section: Clinical Findingsmentioning

confidence: 98%

Section: Klinische Befundeunclassified

Augenbeteiligung bei Graft-versus-Host-Erkrankung

Tappeiner,

Heiligenhaus,

Dietrich-Ntoukas

2024

Klin Monbl Augenheilkd

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“…However, tissue damage in oGHVD is not limited to the ocular surface and the lacrimal gland. Recent pre-clinical and clinical studies have shown that ocular adnexa are involved and Meibomian gland and ocular surface damage correlate with each other ( 51 ).…”

Section: Pathophysiology Of Gvhd and Ocular Gvhdmentioning

confidence: 99%

“…Tear flow cytometry is a novel approach, currently used mainly for research purpose, that allows differentiation of cells non-invasively from tear samples ( 51 ).…”

Section: Diagnosis Of Ocular Gvhdmentioning

confidence: 99%

Challenges and concepts in the diagnosis and management of ocular graft-versus-host disease

Tappeiner

Heiligenhaus²,

Halter³

et al. 2023

Front. Med.

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Graft-versus-host disease (GVHD) is characterized by tissue inflammation in the host following an allogeneic hematopoietic cell transplantation (HCT). The pathophysiology is complex and only incompletely understood yet. Donor lymphocyte interaction with the histocompatibility antigens of the host plays a crucial role in the pathogenesis of the disease. Inflammation may affect multiple organs and tissues, e.g., the gastrointestinal tract, liver, lung, fasciae, vaginal mucosa, and the eye. Subsequently, alloreactive donor-derived T and B lymphocytes may lead to severe inflammation of the ocular surface (i.e., cornea and conjunctiva) and the eyelids. Furthermore, fibrosis of the lacrimal gland may lead to severe dry eye. This review focuses on ocular GVHD (oGVHD) and provides an overview of current challenges and concepts in the diagnosis and management of oGVHD. Ophthalmic manifestations, diagnostic procedures, grading of severity and recommendations for ophthalmic examination intervals are provided. Management of ocular surface disease with lubricants, autologous serum eye drops, topical anti-inflammatory agents and systemic treatment options are described based on the current evidence. Ocular surface scarring and corneal perforation are severe complications of oGVHD. Therefore, ophthalmic screening and interdisciplinary treatment approaches are highly relevant to improve the quality of life of patients and to prevent potentially irreversible visual loss.

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“…Although aGVHD involves the skin, liver, and gastrointestinal (GI) tract, cGVHD is characterized by fibrosis with minimal inflammation, and it may virtually involve any organ, including the eye. 3 Ocular involvement (ocular graft-versus-host disease [oGVHD]) is one of the main features of cGVHD, although it can also occur in aGVHD. It may affect all the layers of the eye but mainly involves the ocular surface.…”

Section: Introductionmentioning

confidence: 99%

Lessons Learned From Ocular Graft versus Host Disease: An Ocular Surface Inflammatory Disease of Known Time of Onset

Quiroga-Garza,

Ruiz-Lozano,

Rodriguez-Gutierrez

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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The ocular surface inflammatory disorders (OSIDs) comprise a group of conditions characterized by persistent inflammation of the ocular surface and adnexal tissues. Systemic autoimmune diseases and hypersensitivity reactions cause them, and, if left untreated, can result in severe inflammatory dry eye, corneal damage, and vision loss. Ocular graft-versus-host disease (oGVHD) forms part of the ocular surface inflammatory disease umbrella. It is a condition occurring after allogeneic hematopoietic stem cell or bone marrow transplantation, usually in chronic graft-versus-host disease. oGVHD can virtually affect any ocular adnexal tissue, especially the meibomian glands, and cause persistent inflammation, tissue fibrosis, and subsequent chronic, severe dry eye disease. Among the OSIDs, oGVHD has the particularity that it has a “time zero,” meaning we know when the disease started. As such, preclinical models have leveraged this to investigate the molecular mechanisms involved in the damage oGVHD causes to the ocular surface. In oGVHD, establishing a “time zero” allows for predicting the clinical course and establishing adequate treatment. This is also possible because the inflammatory infiltration occurs in ocular surface tissues, which are readily accessible. Using oGVHD, we might be able to understand the immune response mechanisms in other OSIDs better (i.e., Sjögren syndrome, Stevens-Johnson syndrome, among others). This review presents an up-to-date overview of the pathogenesis, clinical presentation, and treatment of oGVHD. In addition, we will discuss the value of the “time zero” concept in the study of oGVHD.

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Meibomian Gland Dysfunction: A Route of Ocular Graft-Versus-Host Disease Progression That Drives a Vicious Cycle of Ocular Surface Inflammatory Damage

Cited by 12 publications

References 62 publications

Augenbeteiligung bei Graft-versus-Host-Erkrankung

Augenbeteiligung bei Graft-versus-Host-Erkrankung

Challenges and concepts in the diagnosis and management of ocular graft-versus-host disease

Lessons Learned From Ocular Graft versus Host Disease: An Ocular Surface Inflammatory Disease of Known Time of Onset

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