title: Impact of ocular graft-versus-host disease on visual quality of life in patients after allogeneic stem cell transplantation: questionnaire study.
abstract: OBJECTIVE
  To determine the influence of ocular complications on quality of life (QoL) 3 years after allogeneic stem cell transplantation (allo-SCT).
  
  
  METHODS
  All 54 adult patients that underwent and survived allo-SCT in 2006/2007 in our centre received two questionnaires (VFQ-25: visual function questionnaire-25 and OSDI: ocular surface disease index). In addition, the following data were included: gender, age, underlying disease, presence of chronic and/or ocular graft-versus-host disease (GVHD), number of visits to an ophthalmologist, manifestations of dry eye disease, the duration of follow-up and treatment for ocular GVHD.
  
  
  RESULTS
  Ocular GVHD developed in 26% (14 of 54) of patients and 71% (10 of 14) received treatment for ocular GVHD. The presence of ocular GVHD correlated with the severity of systemic GVHD (correlation coefficient: 0.52, p = 0.00). The Karnofsky scores were significantly lower in the patients with ocular GVHD compared to the patients with no ocular GVHD (p = 0.001). Karnofsky scores were weakly correlated with the severity of systemic GVHD (correlation coefficient: 0.25, p = 0.03. Three years after the all-SCT, OSDI and VFQ-25 scores were significantly impaired in patients with ocular GVHD [mean: 76.5; range (46.1-100) and mean: 31.1; range (0-72.9)] compared to patients with no ocular GVHD [mean: 89.4; range (45.2-100) and mean: 12.9; range (0-58.3); p = 0.02]. The scores of the VFQ-25 were significantly lower in the domains of general health, ocular pain, social functioning and role difficulties.
  
  
  CONCLUSIONS
  The long-term vision-related QoL measured by the OSDI and VFQ-25 was impaired in patients with ocular GVHD.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Hematology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Anjo
authors.initials: A
authors.lastname: Riemens
authors.forename: Liane C J
authors.initials: LC
authors.lastname: Te Boome
authors.forename: Viera
authors.initials: V
authors.lastname: Kalinina Ayuso
authors.forename: Jonas J W
authors.initials: JJ
authors.lastname: Kuiper
authors.forename: Saskia M
authors.initials: SM
authors.lastname: Imhof
authors.forename: Henk M
authors.initials: HM
authors.lastname: Lokhorst
authors.forename: Rothova
authors.initials: R
authors.lastname: Aniki
mesh_terms: D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000523:psychology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous
keywords: allogeneic stem cell transplantation; ocular graft-versus-host disease; ocular surface disease index; quality of life; visual function questionnaire-25