Cornea, Cataract & Refractive Surgery Services, Dr R P Centre, All India Institute of Medical Sciences, New Delhi, India.
Department of Ophthalmology, University of Chicago, USA.
Indian J Ophthalmol. 2021 May;69(5):1038-1050. doi: 10.4103/ijo.IJO_2016_20.
Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.
眼移植物抗宿主病（oGVHD）是造血干细胞移植后的一种并发症，与显著的眼部发病率相关，导致生活质量显著下降。由于复发性 oGVHD 通常对常规治疗有抗性，因此目前尚无治疗方案的共识，这使得管理变得具有挑战性。大多数作者现在根据美国国立卫生研究院共识会议（NIH CC）或国际慢性 oGVHD（ICCGVHD）共识小组提供的标准来诊断和分级该疾病。本文将深入了解 oGVHD 的诊断标准、分类和临床严重程度分级量表。oGVHD 的炎症过程可累及整个眼表面，包括眼睑、睑板腺、角膜、结膜和泪液系统。本研究讨论了它们的不同临床表现和治疗策略。oGVHD 患者在眼表面成像方面的最新进展，如使用睑板腺成像和共聚焦显微镜，可能有助于早期诊断和预测疾病。研究 oGVHD 患者的泪液蛋白质组学和鉴定新的潜在泪液生物标志物是一个令人兴奋的领域，因为它们可能有助于客观诊断疾病并监测治疗反应。
