title: Verification of the new grading scale for ocular chronic graft-versus-host disease developed by the German-Austrian-Swiss consensus conference on chronic GVHD.
abstract: The purpose of the study was to validate a recently proposed new grading system for ocular manifestations of chronic graft-versus-host disease (cGVHD). Diagnosis of cGVHD was based on the NIH consensus criteria. In addition, a grading scale was applied, which has been developed by the German-Austrian-Swiss Consensus Conference on Clinical Practice in cGVHD. Sixty-six patients (male n = 46, female n = 20, mean age 48 years) with ocular cGVHD were included. Application of the proposed Consensus Conference grading revealed inflammatory activity in all patients with mild (33 %), moderate (44 %), or severe inflammation (23 %). Clinical scoring by the NIH scoring system showed that 6 % of patients had mild symptoms; 59 % of patients had moderate dry eye symptoms partially affecting activities of daily living, without vision impairment; and 35 % of patients had severe dry eye symptoms significantly affecting daily activities. Clinical characterization and grading by the Consensus Conference grading scale revealed that ocular cGVHD (1) frequently leads to severe ocular surface disease based on impaired function of the lacrimal glands and involvement of cornea, conjunctiva, and lids; (2) is mostly associated with ongoing inflammatory activity; (3) often leads to functional impairment and reduced quality of life; and (4) is associated with an increased risk for severe, sight-threatening complications.
authors.affiliation: Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany. Blecha@eye-regensburg.de.
authors.forename: Christiane
authors.initials: C
authors.lastname: Blecha
authors.affiliation: Department of Hematology and Oncology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wolff
authors.affiliation: Department of Hematology and Oncology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Holler
authors.affiliation: Department of Hematology and Oncology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Holler
authors.affiliation: Department of Hematology and Oncology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Weber
authors.affiliation: Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Regine
authors.initials: R
authors.lastname: Vogt
authors.affiliation: Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Helbig
authors.affiliation: Department of Ophthalmology, University Medical Center Regensburg, Regensburg, Germany.|Department of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Dietrich-Ntoukas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D002908:Chronic Disease; D015975:Consensus Development Conferences, NIH as Topic; D005128:Eye Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000453:epidemiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D014184:Transplantation, Homologous / Q000009:adverse effects; D014481:United States; D055815:Young Adult
keywords: Grading scale; Ocular chronic graft-versus-host disease; Verification