title: Dry Eye Disease Incidence Associated with Chronic Graft-Host Disease: Nonconcurrent Cohort Study (An American Ophthalmological Society Thesis).
abstract: To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease.
  
  
  
  A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit.
  
  
  
  Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis.
  
  
  
  Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology.
authors: Department of Ophthalmology and Visual Sciences, Division of Cornea and External Disease, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan.
authors: Shahzad I
authors: SI
authors: Mian
authors: Department of Ophthalmology and Visual Sciences, Division of Cornea and External Disease, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, Department of Ophthalmology, Cornea and Ocular Surface Clinic, Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors: Paola
authors: P
authors: De la Parra-Colín
authors: Department of Ophthalmology and Visual Sciences, Division of Cornea and External Disease, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan.
authors: Rafael
authors: R
authors: De Melo-Franco
authors: Department of Ophthalmology and Visual Sciences, Division of Cornea and External Disease, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan.
authors: Christopher
authors: C
authors: Johnson
authors: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan and the Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
authors: Tonatiuh
authors: T
authors: Barrientos-Gutierrez
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000150:complications* / Q000175:diagnosis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007638:Keratoconjunctivitis Sicca / Q000601:surgery*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous