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Travis C. Rumery, Shahzad Mian, Joshua Stein; Ocular Disease Associated with Hematopoietic Stem Cell Transplantation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):570.
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To evaluate the epidemiology and risk factors associated with ocular disease after hematopoietic stem cell transplantation (HSCT).
Claims data from a large, United States managed care network were retrospectively analyzed. ICD-9-CM Billing codes were used to identify patients who underwent autologous or allogeneic HSCT from 2001 to 2009 and to assess the new onset of ocular complications associated with HSCT and whether they vary based on the type of HSCT (autologous vs allogeneic). Comparisons of the proportion of enrollees who experienced GVHD, development of severe dry eyes (DES), conjunctivitis, keratitis, and cataract were performed at 6 weeks, 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years following HSCT.
There were a total of 484 patients who underwent allogeneic HSCT and 94 patients who underwent autologous HSCT during their time in the plan. Among those who underwent allogeneic HSCT, the proportion who developed GVHD was 3.52% at 3 months, 2.96% at 1 year and 5.0% at 5 years. No patients in the autologous HSCT group developed GVHD. The proportion of patients who developed severe DES was higher in the allogeneic group when compared to the autologous group up to 2 years (p=0.0365). The proportion of patients who developed conjunctivitis was similar in both groups at all time points (p>0.2). The proportion of patients who developed keratitis was higher up to 3 months in the allogeneic HSCT group when compared to the autologous HSCT group (p=0.037). A new diagnosis of cataract was more frequent in the allogeneic BMT group up to 6 months after HSCT (p=0.0323).
Ocular disease is common after HSCT. Physicians should be aware of the overall disease burden of ocular GVHD to facilitate appropriate eye care for patients undergoing HSCT in order to minimize ocular morbidity.
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