School of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
Eye (Lond). 2023 Jul;37(10):1982-1992. doi: 10.1038/s41433-022-02288-9. Epub 2022 Nov 4.
Graft-versus-host disease (GVHD) is one of the major complications of allogenic haematopoietic stem cell transplantation (HSCT). The manifestation of ocular GVHD (oGVHD) is variable and may involve cornea, lacrimal gland, conjunctiva, eyelid, and/or nasolacrimal duct. We reviewed and summarized the current managements of oGVHD with specific focus on the emerging therapeutic advances.
PubMed, Web of Science, and Google Scholar were searched for relevant literatures published within 20 years. Keywords used included "Graft-Versus-Host Disease", "GVHD", "ocular", "ocular surface", "ocular GVHD", "oGVHD", "dry eye", "keratitis", etc. RESULTS: Current managements of oGVHD can be classified into topical immunosuppressants, local tear-preservatory treatments, local non-pharmacological/surgical interventions, and systemic treatments. Additionally, some innovative therapies with promising treatment effects have been proposed, including topical target therapies, epitheliotrophic and neurotrophic treatments, recombinant DNase eye drops, mesenchymal stromal cell injection, and more.
Clinical managements of oGVHD are administered in a symptom-based, stepwise manner. The advances in innovative therapies may help improve clinical outcomes, and it is essential that physicians stay updated with these novel treatment options.
移植物抗宿主病（GVHD）是异基因造血干细胞移植（HSCT）的主要并发症之一。眼移植物抗宿主病（oGVHD）的表现多种多样，可能涉及角膜、泪腺、结膜、眼睑和/或鼻泪管。我们回顾并总结了 oGVHD 的当前治疗方法，特别关注新兴的治疗进展。
在 20 年内，我们在 PubMed、Web of Science 和 Google Scholar 上搜索了相关文献。使用的关键词包括“Graft-Versus-Host Disease”、“GVHD”、“ocular”、“ocular surface”、“ocular GVHD”、“oGVHD”、“dry eye”、“keratitis”等。
oGVHD 的当前治疗方法可分为局部免疫抑制剂、局部泪液保存治疗、局部非药物/手术干预和全身治疗。此外，还提出了一些具有有前景的治疗效果的创新疗法，包括局部靶向治疗、上皮营养和神经营养治疗、重组 DNA 酶滴眼液、间充质基质细胞注射等。
oGVHD 的临床治疗采用基于症状的逐步治疗方法。创新疗法的进步可能有助于改善临床结果，医生必须了解这些新的治疗选择。
