Abstract
Purpose: :
To assess the long-term clinical course of dry eye in patients with chronic graft-versus-host disease (GVHD).
Methods: :
A prospective case series of 49 patients with chronic GVHD was conducted. Complete history and ophthalmic examination were performed at baseline and at 36 months (Range, 26-53). All patients received treatment for dry eye.
Results: :
Of the 49 patients, 31 (63%) were alive at the time of the 3-year eye examination. Eleven of the 31 patients were lost to follow-up, eleven declined or were unable to attend the final examination, and 9 patients completed the study. There was an overall improvement in subjective symptoms of dry eye assessed by the Ocular Surface Disease Index© (start vs. endpoint: 36 ± 22 [Range, 4-72] vs. 30 ± 27 [Range, 4-86]; P=0.51). Visual acuity remained stable at approximately 20/20. Lissamine green staining (LGS) improved and Schirmer’s test (with anesthetic) worsened, but neither trend was statistically or clinically significant.
Conclusions: :
Patients with chronic GVHD may have a persistent clinical course of dry eye despite treatment. The long-term prognosis is likely characterized by stable visual acuity, tear production, and LGS, as well as improved quality of life.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: natural history • clinical (human) or epidemiologic studies: outcomes/complications