Chiu Gloria B, Theophanous Christos, Irvine John A
*OD †BA ‡MD Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California (GBC, CT); and Doheny Eye Institute, University of California Los Angeles, Los Angeles, California (JAI).
Optom Vis Sci. 2016 Nov;93(11):1444-1448. doi: 10.1097/OPX.0000000000001003.
To report a case of persistent epithelial defects in a patient with ocular chronic graft-versus-host disease that required coordinated modulation of systemic immunosuppressive treatment and overnight wear of Prosthetic Replacement of the Ocular Surface Ecosystem (BostonSight PROSE, Needham, MA) devices to achieve ocular surface healing.
The case of a 38-year-old male patient who presented with a 2-year history of ocular chronic graft-versus-host disease, ocular burning, pain, light sensitivity, and a 3-week history of bilateral corneal epithelial defects is presented. Standard therapies and an initial PROSE treatment utilizing customized scleral lenses were unsuccessful in resolving his ocular complications. A second trial of PROSE treatment involving overnight wear of the devices in combination with increased systemic immunosuppressant therapy ultimately allowed ocular surface healing and improved his discomfort, vision, and quality of life.
Sight-threatening complications of ocular chronic graft-versus-host disease often require a multidisciplinary approach. Persistent corneal epithelial defects may require increased systemic immunosuppression and extension of PROSE treatment to overnight wear.
报告一例眼部慢性移植物抗宿主病患者持续性上皮缺损的病例，该病例需要系统性免疫抑制治疗的协同调整以及眼表生态系统假体置换（波士顿视力PROSE，马萨诸塞州尼德姆）装置的过夜佩戴，以实现眼表愈合。
介绍了一名38岁男性患者的病例，该患者有2年眼部慢性移植物抗宿主病病史，伴有眼部烧灼感、疼痛、畏光，以及双侧角膜上皮缺损3周病史。标准治疗方法以及最初使用定制巩膜镜的PROSE治疗未能解决其眼部并发症。第二次PROSE治疗试验包括装置过夜佩戴并增加全身免疫抑制剂治疗，最终实现了眼表愈合，并改善了他的不适、视力和生活质量。
眼部慢性移植物抗宿主病的视力威胁性并发症通常需要多学科方法。持续性角膜上皮缺损可能需要增加全身免疫抑制并将PROSE治疗延长至过夜佩戴。
