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D. S. Jacobs, P. Rosenthal; Boston Ocular Surface Prosthesis Improves Visual Function in Patients With Ocular Surface Disease From Chronic Graft-Versus-Host Disease. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2362.
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To determine the impact of wearing the Boston Ocular Surface Prosthesis (BOSP) on visual function in patients with ocular surface disease related to chronic graft-versus-host disease (cGvHD).
All patients referred to this institution for consideration of treatment with the BOSP (formerly known as Boston Scleral Lens) from January through June 2006 were administered the NEI VFQ-25 at entry, and again 6 months later. Our patient database was sorted by diagnosis identifying the cGvHD subgroup (n=16) in this cohort. The characteristics of this subgroup were extracted by data base analysis and retrospective chart review. This subgroup consists of 12 males and 14 females of ages 28 - 63 years (mean = 49). Underlying malignancy, type of transplant, and prior conventional ophthalmic therapy was tabulated and is reported. Baseline composite NEI VFQ-25 scores and self-reported general health status scores in this subgroup and scores at 6 month follow-up are reported, along with mean change in score. Scores are reported on scale 0 - 100, with 100 = highest level of function. The unpaired t-test was used to compare baseline composite scores of patients fitted vs. not fitted. The paired t-test was used to evaluate change in composite and self-reported general health score in those fitted.
Mean baseline composite score on the NEI VFQ-25 was 62 (range 35-91, n=16). Of these 16 patients, 13 were fitted with the BOSP. Mean score for patients not fitted was 74 (n=3), whereas mean score for patients fitted was 59 (n=13), (P = 0.20, unpaired t-test ). NEI VFQ-25 scores of patients fitted and who had 6 month followup data (n=12), had mean = 57 (S.E = 5.06) at baseline and mean = 77 (S.E. = 5.52) at 6 months, with mean change in score = +20, (P <0.0003, paired t-test). Self-reported general health status was not significantly different at baseline (mean = 60) and 6 months (mean = 56, P=0.6147, paired t-test), in this group of patients. No patient categorized his or her general health as poor.
The BOSP significantly improves visual function in patients with ocular surface disease, unresponsive to conventional therapy, from cGvHD, in a sample that includes patients of both sexes, and a broad range of ages, underlying malignancies, and self-reported general health states. There was no concurrent improvement in general health status in this subgroup to explain this finding.
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