Ocular graft-versus-host disease after allogeneic stem cell transplantation.
OBJECTIVE
To determine the prevalence and manifestations of ocular graft-versus-host disease (GvHD) after allogeneic stem cell transplantation (allo-SCT).


METHODS
Prospective study of 101 consecutive patients who received allo-SCT from 2004 to 2007. All patients received ophthalmologic examination for 3 months after allo-SCT, and those with ocular complaints were evaluated at 12 and 24 months thereafter. We registered ophthalmologic and hematological data, including the indication for allo-SCT, occurrence of systemic and ocular GvHDs, ocular manifestations, and various ocular treatments.


RESULTS
Over time, ocular GvHD developed in 54% of patients and consisted mainly of dry eyes and conjunctivitis, which increased in severity during follow-up; blepharitis and uveitis were less often encountered. Acute systemic GvHD, especially the involvement of mouth and skin, was strongly associated with ocular GvHD at 3 months (P = 0.000). Chronic GvHD was associated with the occurrence of ocular GvHD (P = 0.000), especially with the development of the dry eye. Although eye symptoms affecting activities of daily living were reported in 24 of 54 patients (44%) and 16 of 54 patients (30%) experienced temporary loss of visual acuity of more than 2 Snellen lines, only 1 developed permanent unilateral loss (counting fingers) because of ischemic vasculopathy. Cataract development was not encountered, and only 1 eye developed intraocular infection.


CONCLUSIONS
Ocular GvHD develops in a substantial part of patients after allo-SCT and decreases the activities of daily living.
Westeneng
Arnaud C
AC
Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.
Hettinga
Ymkje
Y
Lokhorst
Henk
H
Verdonck
Leo
L
van Dorp
Suzanne
S
Rothova
Aniki
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001762:Blepharitis / Q000209:etiology; D003231:Conjunctivitis / Q000209:etiology; D015352:Dry Eye Syndromes / Q000209:etiology; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014605:Uveitis / Q000209:etiology; D055815:Young Adult