Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria.

Jacobs R, Tran U, Chen H, Kassim A, Engelhardt BG, Greer JP, Goodman SG, Clifton C, Lucid C, Vaughan LA, Savani BN, Jagasia M
Bone Marrow Transplant. 2012 47 (11): 1470-3

PMID: 22484321 · DOI:10.1038/bmt.2012.56

We studied 172 patients for development of ocular graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) from 2002 to 2009. Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative incidence of 35% (95% confidence interval (CI), 28-43). The positive and negative predictive values of a Schirmer I test score (using 5 mm as a cutoff) in predicting ocular GVHD (day 100) were 41 and 82%, respectively. In patients with ocular GVHD beyond day 100, extraocular manifestations of GVHD preceded the development of ocular GVHD in most patients (27 of 33, 81%). Prior acute skin GVHD (odds ratio 2.57, 95% CI 1.17-5.64, P=0.019) and male recipients of female donors (odds ratio 2.57, 95% CI 1.09-6.06, P=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD.

MeSH Terms (16)

Adult Aged Consensus Development Conferences, NIH as Topic Dry Eye Syndromes Eye Diseases Female Graft vs Host Disease Hematopoietic Stem Cell Transplantation Humans Male Middle Aged National Institutes of Health (U.S.) Prevalence Risk Factors United States Young Adult

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