September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Chronic Ocular Graft Versus Host Disease: An Investigation of Initial Symptoms, Beneficial Treatments, and Current Functionality of Patients
Author Affiliations & Notes
  • Maximilian Roydon Padilla
    Ophthalmology, University of South Florida School of Medicine, Tampa, Florida, United States
  • Roshni Ranjit
    Ophthalmology, University of South Florida School of Medicine, Tampa, Florida, United States
  • Edgar Espana
    Ophthalmology, University of South Florida School of Medicine, Tampa, Florida, United States
  • Footnotes
    Commercial Relationships   Maximilian Padilla, None; Roshni Ranjit, None; Edgar Espana, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6212. doi:
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      Maximilian Roydon Padilla, Roshni Ranjit, Edgar Espana; Chronic Ocular Graft Versus Host Disease: An Investigation of Initial Symptoms, Beneficial Treatments, and Current Functionality of Patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6212.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The purpose of our clinical case series is to identify the initial presenting ocular symptoms of a subset of patients presenting with GVHD with the goal of quantifying the functionality of patients affected by this life changing disease, and identifying the most effective treatments.

Methods : GVHD eye patients were surveyed. Statistical analysis including correlation coefficients
were then used to analyze the data.

Results : Our subset of 19 patients with bone marrow transplants from February 1996 to May 2014 demonstrated that ocular dryness (63%), general irritation (58%) light sensitivity (53%), and red eyes (47%) were the most common presenting symptoms. Coefficient calculations showed strong correlation in the categories of dryness (r=0.9528), light sensitivity (r=0.7658) and red eyes (r=0.8039), along with moderate correlation in the category of ocular irritation (r=0.7081). The most successful overall treatments for general GVHD eye symptoms were: lubricating eye drops (44% of patients), contact lenses (17%), Restasis (17%), Unisol (5%), scleral contact
lenses (5%), and topical steroids (11%). Patients treated with Restasis for their symptoms showed: no improvement (53%) , improvement (37%), no change (5%), allergic reaction (5%). Over a third of patients (36%) reported their symptoms as being severe according to the National Institutes of Health Eye Score.

Conclusions : Ocular dryness was the most severe ocular symptom. The most effective overall treatment for this eye disease was shown to be lubricating eye drops. Over one half of the patients studied did not have relief with Restasis. Over one third of patients report that their ocular GVHD symptoms are significantly affecting their activities of daily living including their ability to work due to the severity of symptoms or loss of vision due to dry eyes. The largest goal is that these results will provide more insight into the initial symptoms of ocular GVHD and allow for a better understanding of the performance, treatment and functionality of patients suffering from the devastating chronicity of this disease, and the best treatment for symptoms.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

This figure illustrates the overall most sucessfull treatments for Graft Verse Host Disease ocular symptoms.

This figure illustrates the overall most sucessfull treatments for Graft Verse Host Disease ocular symptoms.

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