Chronic ocular GVHD: limbal and conjunctival stem cell allografts from the same hematopoietic stem cell donor

doi:10.18240/ijo.2018.09.24

Cited by 2 publications

(3 citation statements)

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“…The progression from the stage of epithelial ulceration to perforation tends to be rapid and is often refractory to standard medical or surgical treatment modalities. [ 38 39 40 41 ] Progressive ocular surface inflammation leads to corneal neovascularization, conjunctivalization, and less commonly limbal stem cell deficiency, which will adversely affect visual acuity. [ 41 42 43 44 ] Decreased corneal sensation tends to predispose the development of neurotrophic ulceration.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Mucous membrane grafts and skin grafts may be required for the management of cicatricial lid disease. Allogenic limbal stem cell transplantation from the same hematopoietic stem cell donor,[ 41 43 44 127 ] lamellar keratoplasty,[ 128 ] tectonic patch grafts [ Fig. 2b ], and penetrating keratoplasty[ 126 ] are performed in a limited capacity and only as a final effort, given a poor prognosis for graft survival because of severe preexisting ocular surface inflammation.…”

Section: Treatmentmentioning

confidence: 99%

“…Ocular surface stem cell transplantation using conjunctival and limbal allografts obtained from the patient’s HSCT donor has been reported to be a promising treatment modality associated with good long-term survival of the graft. [ 41 43 44 ] Keratoprosthesis may also be considered in severe cases for visual rehabilitation with bilateral blindness; osteo-odonto keratoprosthesis has been successfully performed in a few cases. [ 129 ]…”

Section: Treatmentmentioning

confidence: 99%

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Update on ocular graft-versus-host disease

Nair

Vanathi

Mukhija

et al. 2021

Indian Journal of Ophthalmology

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Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.

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