Department of Ophthalmology (M.E.Q.-G., R.E.R.-L., S.M., S.K., V.L.P.), Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC; Bascom Palmer Eye Institute (M.E.Q.-G., R.E.R.-L., L.A.R.-G., A.K., S.M., S.K., V.L.P.), University of Miami, Miami, FL; and Department of Ophthalmology (K.M.-N.), University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, Mexico.
Eye Contact Lens. 2024 May 1;50(5):212-221. doi: 10.1097/ICL.0000000000001082. Epub 2024 Mar 22.
The ocular surface inflammatory disorders (OSIDs) comprise a group of conditions characterized by persistent inflammation of the ocular surface and adnexal tissues. Systemic autoimmune diseases and hypersensitivity reactions cause them, and, if left untreated, can result in severe inflammatory dry eye, corneal damage, and vision loss. Ocular graft-versus-host disease (oGVHD) forms part of the ocular surface inflammatory disease umbrella. It is a condition occurring after allogeneic hematopoietic stem cell or bone marrow transplantation, usually in chronic graft-versus-host disease. oGVHD can virtually affect any ocular adnexal tissue, especially the meibomian glands, and cause persistent inflammation, tissue fibrosis, and subsequent chronic, severe dry eye disease. Among the OSIDs, oGVHD has the particularity that it has a "time zero," meaning we know when the disease started. As such, preclinical models have leveraged this to investigate the molecular mechanisms involved in the damage oGVHD causes to the ocular surface. In oGVHD, establishing a "time zero" allows for predicting the clinical course and establishing adequate treatment. This is also possible because the inflammatory infiltration occurs in ocular surface tissues, which are readily accessible. Using oGVHD, we might be able to understand the immune response mechanisms in other OSIDs better (i.e., Sjögren syndrome, Stevens-Johnson syndrome, among others). This review presents an up-to-date overview of the pathogenesis, clinical presentation, and treatment of oGVHD. In addition, we will discuss the value of the "time zero" concept in the study of oGVHD.
眼表面炎症性疾病（OSIDs）包括一组以眼表面和附属组织持续炎症为特征的疾病。全身性自身免疫性疾病和过敏反应会引起这些疾病，如果不加以治疗，可能会导致严重的炎症性干眼症、角膜损伤和视力丧失。眼移植物抗宿主病（oGVHD）是眼表面炎症性疾病伞的一部分。它是一种在异基因造血干细胞或骨髓移植后发生的疾病，通常发生在慢性移植物抗宿主病中。oGVHD几乎可以影响任何眼附属组织，特别是睑板腺，并导致持续的炎症、组织纤维化以及随后的慢性、严重干眼症。在 OSIDs 中，oGVHD 的特殊性在于它有一个“时间零”，这意味着我们知道疾病何时开始。因此，临床前模型利用这一点来研究 oGVHD 对眼表面造成损害的分子机制。在 oGVHD 中，确定“时间零”可以预测临床病程并建立适当的治疗方法。这也是可能的，因为炎症浸润发生在眼表面组织中，这些组织很容易接近。利用 oGVHD，我们或许能够更好地理解其他 OSIDs 的免疫反应机制（即干燥综合征、史蒂文斯-约翰逊综合征等）。本文综述了 oGVHD 的发病机制、临床表现和治疗的最新进展。此外，我们还将讨论“时间零”概念在 oGVHD 研究中的价值。
