Tao Yong, Cui Haoran, Zhang Shuang, Zhang Tao
Department of Ophthalmology Beijing Chaoyang Hospital, Capital Medical University Beijing China.
Clin Case Rep. 2024 Jul 12;12(7):e9182. doi: 10.1002/ccr3.9182. eCollection 2024 Jul.
Traditional treatment options are often insufficient in treating severe dry eyes caused by systemic diseases. This case demonstrates that ocular immersion hydrotherapy significantly alleviated symptoms and ocular surface inflammation in ocular graft-versus-host disease. Based on these findings, we propose it as a promising option for managing severe dry eye disease.
This case report investigates the efficacy of ocular immersion hydrotherapy (OIH) in treating severe dry eye secondary to ocular graft-versus-host disease (oGVHD). A 35-year-old female with a history of acute myeloid leukemia-M2 and subsequent hematopoietic stem cell transplantation (HSCT) developed high-intensity oGVHD unresponsive to conventional treatments, including topical corticosteroids and lubricants. We introduced OIH, utilizing sterilized swimming goggles filled with intraocular irrigating solutions, providing a moist microenvironment for the ocular surface. Symptoms were significantly relieved after treatment. Corneal filaments and epithelial defects were significantly reduced, and in vivo confocal microscopy (IVCM) demonstrated resolution of inflammation and reappearance of corneal nerves. This case indicates that OIH could be a promising therapeutic approach for severe dry eye conditions arising from oGVHD, particularly for patients refractory to traditional treatments. Further studies are warranted to elucidate the long-term benefits and mechanisms of OIH in oGVHD management.
传统治疗方法在治疗由全身性疾病引起的严重干眼症时往往不够充分。本病例表明，眼部浸泡水疗法可显著减轻眼部移植物抗宿主病的症状和眼表炎症。基于这些发现，我们认为它是治疗严重干眼症的一个有前景的选择。
本病例报告研究了眼部浸泡水疗法（OIH）治疗继发于眼部移植物抗宿主病（oGVHD）的严重干眼症的疗效。一名35岁女性，有急性髓系白血病-M2病史及随后的造血干细胞移植（HSCT），发生了高强度oGVHD，对包括局部用皮质类固醇和润滑剂在内的传统治疗无反应。我们引入了OIH，使用装有眼内冲洗液的无菌泳镜，为眼表提供一个湿润的微环境。治疗后症状明显缓解。角膜丝状物和上皮缺损显著减少，共聚焦显微镜检查（IVCM）显示炎症消退和角膜神经重新出现。本病例表明，OIH可能是治疗由oGVHD引起的严重干眼症的一种有前景的治疗方法，特别是对于传统治疗无效的患者。有必要进一步研究以阐明OIH在oGVHD治疗中的长期益处和机制。
