Book contents
- Frontmatter
- Contents
- List of Contributors
- Preface
- PART I GENERAL PRINCIPLES
- PART II CLINICAL MANAGEMENT
- PART III ORGAN SITE OR SYSTEM-SPECIFIC MANIFESTATIONS
- 16 Cutaneous Manifestations of Chronic Graft versus Host Disease
- 17 Oral Chronic Graft versus Host Disease
- 18 Chronic Ocular Graft versus Host Disease
- 19 Gynecological Manifestations of Chronic Graft versus Host Disease
- 20 Gastrointestinal and Hepatic Manifestations of Chronic Graft versus Host Disease
- 21 Chronic Graft versus Host Disease and the Lung
- 22 Hematologic Complications of Chronic Graft versus Host Disease
- 23 Neurological Manifestations of Chronic Graft versus Host Disease
- 24 Rehabilitation Evaluation and Treatment of Patients with Chronic Graft versus Host Disease
- 25 Infections
- 26 Endocrine and Metabolic Effects of Chronic Graft versus Host Disease
- 27 Other Manifestations of Chronic Graft versus Host Disease
- 28 Psychosocial Issues in Chronic Graft versus Host Disease
- 29 Secondary Malignancies and Other Late Effects
- 30 Health-Related Quality of Life (HRQOL) in Chronic Graft versus Host Disease
- PART IV SPECIAL CONSIDERATIONS IN CHRONIC GVHD
- Index
- Plate section
18 - Chronic Ocular Graft versus Host Disease
from PART III - ORGAN SITE OR SYSTEM-SPECIFIC MANIFESTATIONS
Published online by Cambridge University Press: 26 August 2009
- Frontmatter
- Contents
- List of Contributors
- Preface
- PART I GENERAL PRINCIPLES
- PART II CLINICAL MANAGEMENT
- PART III ORGAN SITE OR SYSTEM-SPECIFIC MANIFESTATIONS
- 16 Cutaneous Manifestations of Chronic Graft versus Host Disease
- 17 Oral Chronic Graft versus Host Disease
- 18 Chronic Ocular Graft versus Host Disease
- 19 Gynecological Manifestations of Chronic Graft versus Host Disease
- 20 Gastrointestinal and Hepatic Manifestations of Chronic Graft versus Host Disease
- 21 Chronic Graft versus Host Disease and the Lung
- 22 Hematologic Complications of Chronic Graft versus Host Disease
- 23 Neurological Manifestations of Chronic Graft versus Host Disease
- 24 Rehabilitation Evaluation and Treatment of Patients with Chronic Graft versus Host Disease
- 25 Infections
- 26 Endocrine and Metabolic Effects of Chronic Graft versus Host Disease
- 27 Other Manifestations of Chronic Graft versus Host Disease
- 28 Psychosocial Issues in Chronic Graft versus Host Disease
- 29 Secondary Malignancies and Other Late Effects
- 30 Health-Related Quality of Life (HRQOL) in Chronic Graft versus Host Disease
- PART IV SPECIAL CONSIDERATIONS IN CHRONIC GVHD
- Index
- Plate section
Summary
INTRODUCTION
Chronic ocular graft versus host disease is one of the most common manifestations of chronic GVHD (cGVHD). It has been well recognized from the early allogeneic transplantation experience. Ocular GVHD affects approximately 60–80% of patients with cGVHD and can cause significant decrease in quality of life with high morbidity. The most common form of chronic ocular GVHD is dry eye syndrome (DES) with lacrimal gland dysfunction (reduced aqueous tear production) and keratoconjunctivitis sicca (KCS). Much of the early chronic ocular GVHD literature came from the experience at Johns Hopkins and elsewhere in the early 1980s. Since then, various studies and observations have been made in pathophysiology and in clinical experience in chronic ocular GVHD, in particular in treatment paradigm of organ-specific GVHD in the era of graft versus tumor considerations. National Institute of Health (NIH) Consensus Development Project on Criteria for Clinical Trials in Chronic Graft versus Host Disease published six papers, of which four papers are relevant to the chronic ocular GVHD. This chapter will describe in detail the clinical manifestations, diagnosis, pathophysiology, and management of chronic ocular GVHD and summarize the relevance of the NIH Consensus to ophthalmology.
CLINICAL MANIFESTATIONS
Dry eye syndrome/KCS is the hallmark of chronic ocular GVHD. An earlier study noted that over 80% of patients with cGVHD experienced KCS. A later, multicenter retrospective study showed that 69% of patients who experienced KCS posttransplantation had cGVHD.
- Type
- Chapter
- Information
- Chronic Graft Versus Host DiseaseInterdisciplinary Management, pp. 199 - 206Publisher: Cambridge University PressPrint publication year: 2009
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