Update on ocular graft versus host disease

Abstract

To summarize recent findings regarding the clinical spectrum, pathophysiology, and treatment of ocular graft versus host disease. Ocular graft versus host disease is a common sequela of allogeneic hematopoietic transplantation affecting up to 80% of chronic graft versus host disease patients. Clinical features of ocular graft versus host disease encompass all parts of the eye, from the lid to the choroids, although ocular graft versus host disease is most commonly viewed as a disease of the ocular surface, with the conjunctiva and lacrimal gland most commonly affected. Clinical features of ocular graft versus host disease (keratoconjunctivitis sicca, cicatricial conjunctivitis, scleritis, and others) mirror other inflammatory ocular conditions associated with autoimmune/collagen vascular diseases. Immunohistochemistry studies of lacrimal gland dysfunction and conjunctival inflammation in chronic ocular graft versus host disease are summarized. Current diagnosis and treatment of chronic graft versus host disease are outlined in the recent publications from the National Institute of Health Chronic graft versus host disease Consensus Workshops, and the information relevant to ocular graft versus host disease is delineated. Ocular graft versus host disease evaluation, diagnosis, and management should be approached in a multidisciplinary fashion in the context of the patient's overall graft versus host disease status.