title: Topical corticosteroid therapy for cicatricial conjunctivitis associated with chronic graft-versus-host disease.
abstract: A retrospective chart review was performed on seven patients treated with topical ocular corticosteroid therapy for progressive cicatricial conjunctivitis associated with chronic graft-versus-host disease (GVHD) following hematopoietic stem cell transplantation. A clinical grading criteria for conjunctival GVHD based on the degree of cicatrization was developed and patients graded prior to therapy. During the treatment course, the dose and frequency of topical corticosteroids and clinical outcomes were recorded. A complete response was defined as a complete resolution of the conjunctival hyperemia with either total resolution of the conjunctival fibrovascularization or presence of inactive conjunctival scarring. Prednisolone acetate 1% eye drops were used in a total of eight courses of therapy in seven patients. A complete response was documented in all seven patients with a total treatment duration of 7 weeks (median, range: 3-16 weeks). Additional studies are required to determine the long-term safety and efficacy of topical corticosteroids for cicatricial conjunctivitis associated with ocular GVHD in the context of a randomized, prospective clinical trial.
authors.affiliation: National Eye Institute/NIH, 10/10S229, 110 Center Drive, MSC 1863, Bethesda, MD 20892-1863, USA. robinsonm@nei.nih.gov
authors.forename: M R
authors.initials: MR
authors.lastname: Robinson
authors.forename: S S
authors.initials: SS
authors.lastname: Lee
authors.forename: B I
authors.initials: BI
authors.lastname: Rubin
authors.forename: A S
authors.initials: AS
authors.lastname: Wayne
authors.forename: S Z
authors.initials: SZ
authors.lastname: Pavletic
authors.forename: M R
authors.initials: MR
authors.lastname: Bishop
authors.forename: R
authors.initials: R
authors.lastname: Childs
authors.forename: A J
authors.initials: AJ
authors.lastname: Barrett
authors.forename: K G
authors.initials: KG
authors.lastname: Csaky
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000378:metabolism / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D002908:Chronic Disease; D002921:Cicatrix / Q000188:drug therapy*; D003231:Conjunctivitis / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000494:pharmacology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; C009935:prednisolone acetate; D011239:Prednisolone