Okuläre Graft-versus-Host-Disease

Westekemper, Henrike; Scholz, Simone L.; Thomasen, Henning; Halfwassen, Christian; Steuhl, Klaus‐Peter

doi:10.1007/s00347-017-0488-9

Cited by 10 publications

(4 citation statements)

References 32 publications

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“…Besides, photophobia, burning sensation, foreign body sensation, and fluctuating vision indicated further corneal lesion, for example, punctate keratopathy fusion, filamentary keratitis, corneal ulcer, and corneal perforation occurred in 10%–40% eyes of this group. In our study, 22.8% of chronic ocular GVHD patients developed severe ocular complications; spontaneous corneal perforation, corneal vascularization, and even endophthalmitis have been reported before [ 17 – 19 ]. Moreover, chronic ocular GVHD greatly impairs patient's vision-related quality of life and affects their educational level, job position, and underlying disease [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 50%

Manifestation of Clinical Categories of Ocular Graft-versus-Host Disease

Qiu

Hong

Peng

2018

Journal of Ophthalmology

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This study aims at improving the understanding of the subjective symptoms and signs of two different clinical categories of ocular graft-versus-host disease. After reviewing and screening 193 posthematopoietic stem cell transplantation (HSCT) patients of Peking University Third Hospital, we enrolled 148 (21 acute ocular GVHD, 127 chronic ocular GVHD). Patients' subjective symptoms, ocular parameters, and typical ocular signs were collected and evaluated at the same visit. Classic acute ocular GVHD patients had variable levels of conjunctival involvement but few had keratopathy; increased mucus secretion (21 of 21, 100.0%), red eye (19 of 21, 90.5%), and lacrimation (11 of 21, 52.4%) were the characteristic symptoms. The classic chronic ocular group had severe eye dryness and further corneal lesions, including filamentary keratitis, corneal ulcer, and corneal vascularization. Eye dryness (115 of 127, 90.6%), increased fibrous secretion (53 of 127, 41.7%), photophobia (50 of 127, 39.4%), and alacrimia (45 of 127, 35.4%) were the most common symptoms. Although 44.1% (56 of 127) of these patients had a history of acute ocular GVHD episodes, most were overlooked, so they did not receive stepwise evaluation and treatment. Management of ocular GVHD is very challenging and requires cooperation among disciplines.

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Section: Discussionmentioning

confidence: 50%

Manifestation of Clinical Categories of Ocular Graft-versus-Host Disease

Qiu

Hong

Peng

2018

Journal of Ophthalmology

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“…Due to the severe inflammatory reaction and fibrosis in the LG, meibomian gland, and eyelid in patients with ocular GVHD, the cornea also often suffers secondary complications. Typically, patients present with pain, photophobia, vision impairment, and high-frequency application of tear substitutes, which significantly affects the patient’s activities of daily living ( 41 ). Corneal epithelial damage can be observed under slit lamp examination, manifesting as punctate keratopathy, filamentous keratitis, and persistent epithelial defects.…”

Section: Pathogenic Mechanism and Novel Therapeutic Targetsmentioning

confidence: 99%

Recent advances in ocular graft-versus-host disease

Cheng

Huang

et al. 2023

Front. Immunol.

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Ocular graft-versus-host-disease (GVHD) remains a significant clinical complication after allogeneic hematopoietic stem cell transplantation. Impaired visual function, pain, and other symptoms severely affect affected individuals’ quality of life. However, the diagnosis of and therapy for ocular GVHD involve a multidisciplinary approach and remain challenging for both hematologists and ophthalmologists, as there are no unified international criteria. Through an exploration of the complex pathogenesis of ocular GVHD, this review comprehensively summarizes the pathogenic mechanism, related tear biomarkers, and clinical characteristics of this disease. Novel therapies based on the mechanisms are also discussed to provide insights into the ocular GVHD treatment.

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“…19 Amniotic membranes (AM), either cryopreserved or dehydrated, have been used as salvage therapy to heal persistent epithelial defects in many corneal conditions. [155][156][157][158][159][160][161] An amniotic membrane acts as physical barrier that protects the epithelium as it heals, reduces pain, and has anti-inflammatory substances that promote epithelial growth and repair. One caution with cryopreserved AM is it increases the risk of disease transmission in susceptible immunocompromised patients.…”

Section: E16mentioning

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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Okuläre Graft-versus-Host-Disease

Abstract: Systematic diagnosis of ocular GvHD helps to prevent corneal complications or support early therapeutic intervention. An interdisciplinary approach to diagnosis and treatment planning is recommended, in order to optimize local and systemic immunosuppressive therapy.

Cited by 10 publications

References 32 publications

Manifestation of Clinical Categories of Ocular Graft-versus-Host Disease

Manifestation of Clinical Categories of Ocular Graft-versus-Host Disease

Recent advances in ocular graft-versus-host disease

Chronic Ocular Graft Versus Host Disease: An Update and Review

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