Department of Cornea, External Disease and Refractive Surgery, Department of Ophthalmology, University of South Florida, Tampa, FL, USA.
Graefes Arch Clin Exp Ophthalmol. 2013 May;251(5):1257-66. doi: 10.1007/s00417-013-2301-z. Epub 2013 Mar 17.
Graft versus H\host disease (GVHD) can be a devastating complication following bone marrow transplantation. Acute or chronic systemic GVHD can be lethal, and severe damage of different organs and tissues can occur with both types of GVHD. Ocular involvement, either in an acute or chronic presentation, may range from mild to severe with accompanying vision loss present in 60-90 % of patients. Chronic ocular GVHD, the most common form of GVHD, affects mainly the lacrimal gland, meibomian glands, cornea and conjunctiva, mimicking other immunologically mediated inflammatory diseases of the ocular surface without specific symptoms or signs. However, dry eye disease is the main manifestation of GVHD. The long-term treatment of ocular GVHD continues to be challenging and involves a multidisciplinary approach wherein the ophthalmologist plays a major role. Besides systemic immunosuppression and ocular lubricants, topical steroids and topical cyclosporine are commonly prescribed. Newer therapeutic interventions for moderate and severe ocular GVHD include the use of serum eye drops and scleral contact lenses. In this manuscript, we review the mechanisms, clinical findings, and treatment of ocular GVHD.
移植物抗宿主病（GVHD）是骨髓移植后一种严重的并发症。急性或慢性系统性 GVHD 可能是致命的，两种类型的 GVHD 均可导致不同器官和组织的严重损伤。眼部受累，无论是急性还是慢性表现，其严重程度不一，伴有视力丧失的患者占 60-90%。慢性眼部 GVHD 是最常见的 GVHD 类型，主要影响泪腺、睑板腺、角膜和结膜，其临床表现类似于其他免疫介导的眼表炎症性疾病，但无特异性症状或体征。然而，干眼症是 GVHD 的主要表现。眼部 GVHD 的长期治疗仍然具有挑战性，需要多学科的治疗方法，其中眼科医生发挥着重要作用。除了全身免疫抑制和眼部润滑剂外，还常处方局部皮质类固醇和局部环孢素。针对中度和重度眼部 GVHD 的新治疗方法包括血清滴眼剂和巩膜接触镜的应用。在本文中，我们回顾了眼部 GVHD 的发病机制、临床发现和治疗方法。
