September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparison of Treatment Efficacy of Low-dose Topical Steroid in Dry Eye Disease With and Without Ocular Graft-Versus-Host-Disease
Author Affiliations & Notes
  • Jia Yin
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Ahmad Kheirkhah
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Thomas H Dohlman
    Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • Ujwala S Saboo
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Pedram Hamrah
    Ophthalmology, Tufts University / New England Eye Center, Boston, Massachusetts, United States
  • Reza Dana
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jia Yin, None; Ahmad Kheirkhah, None; Thomas Dohlman, None; Ujwala Saboo, None; Pedram Hamrah, None; Reza Dana, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5693. doi:
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      Jia Yin, Ahmad Kheirkhah, Thomas H Dohlman, Ujwala S Saboo, Pedram Hamrah, Reza Dana; Comparison of Treatment Efficacy of Low-dose Topical Steroid in Dry Eye Disease With and Without Ocular Graft-Versus-Host-Disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5693.

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

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Abstract

Purpose : To compare the response of dry eye disease (DED) signs and symptoms to low-dose topical steroid treatment in patients with and without ocular graft-versus-host-disease (GVHD).

Methods : This retrospective study included 22 patients with DED (12 with ocular GVHD and 10 without ocular GVHD). All patients had moderate to severe DED with an Ocular Surface Disease Index (OSDI) score >22 and corneal fluorescein staining (CFS) ≥ 4 (National Eye Institute grading scale, 0-15). Patients were treated with topical loteprednol etabonate 0.5% ophthalmic suspension twice daily for 4 weeks. Symptom questionnaires including OSDI and Symptom Assessment in Dry Eye (SANDE) as well as clinical signs including CFS, conjunctival staining with lissamine green, tear break-up time and Schirmer's test were compared between groups before and after treatment.

Results : At baseline, there were no significant differences between the GVHD group and non-GVHD group in terms of age, gender, or DED symptoms and signs. After 4 weeks of treatment, DED symptoms improved significantly more in non-GVHD compared with GVHD patients (35.1±14.4% decrease versus 5.7 ± 23.5% increase, respectively, in OSDI score, P<0.001; 23.3 ± 34.4% decrease versus 1.4 ± 29.9% increase, respectively, in SANDE score, P=0.04). Compared with baseline, the CFS score was significantly reduced in the non-GVHD group (41.8 ± 34.5% decrease, P=0.02), but not in the GVHD group (4.5 ± 87.6% increase, P=0.85). There were no significant changes in conjunctival staining, tear break-up time, or Schirmer's scores in either group after treatment.

Conclusions : Even with similar clinical severity of DED, patients with ocular GVHD have a less favorable response to low-dose topical steroid therapy compared with those without ocular GVHD. A more aggressive therapy, therefore, may be recommended in these cases.

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

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