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. 2024 Sep 30:18:2731-2739.
doi: 10.2147/OPTH.S463526. eCollection 2024.

Chronic Ocular GVHD Treatment at Two Locations of a Tertiary Referral Center

Muhammad B Qureshi  1 , Jose O Garcia  1 , Jaxon Quillen  2 , Carolyn Mead-Harvey  2 , Christina Wentz  3 , Cherie B Nau  4 , Muriel Schornack  4 , Keith Baratz  4 , Sanjay V Patel  4 , Joanne Shen  5
Affiliations

Chronic Ocular GVHD Treatment at Two Locations of a Tertiary Referral Center

Muhammad B Qureshi et al. Clin Ophthalmol. .

Abstract

Purpose: To compare baseline characteristics and treatment of chronic ocular graft-versus-host disease (oGVHD) patients in two treatment locations.

Patients and methods: Patients diagnosed with definite chronic oGVHD between September 1, 2014 and September 20, 2021 at two locations were identified. IRB-approved retrospective chart review was conducted for the following data: demographic information, ocular surface disease index (OSDI), corneal fluorescein staining (CFS), and treatment(s) used. Differences by site were assessed using Pearson's Chi-Square tests and two-sample t-tests; differences by time were assessed using paired t-tests.

Results: At baseline, Clinic 1 (C1) patients had a worse mean OSDI score (47.8 vs 36.3, p = 0.011) and CFS in both OD (1.3 vs 0.8, p = 0.005) and OS (1.3 vs 0.6, p < 0.001) compared to Clinic 2 (C2). Comparing baseline to endpoint, C1 patients experienced an improvement in OSDI (-17.26, p < 0.001), CFS OD (-0.50, p < 0.001), and CFS OS (-0.51, p < 0.001) at C1. Change in OSDI, CFS OD, or CFS OS was not statistically significant at C2. Despite similar follow-up length, C1 demonstrated more clinic visits (10.4 vs 3.4, p < 0.001) and more treatment trials (4.9 vs 2.4, p < 0.001) compared to C2. Punctal plugs (85.5% vs 61.2%, p = 0.002), punctal cautery (69.7% vs 28.6%, p < 0.001), topical steroids (72.4% vs 22.4%, p < 0.001), and autologous serum tears (AST) (52.6% vs 8.2%, p < 0.001) were used more frequently at C1 than at C2.

Conclusion: oGVHD patients at C1 experienced significant improvement in OSDI and corneal fluorescein staining and compared to patients at C2, had more frequent follow-up and use of punctal plugs, punctal cautery, topical steroids, and AST.

Keywords: GVHD; KCS; chronic GVHD; dry eye disease; graft-versus-host disease; keratoconjunctivitis sicca; ocular GVHD.

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Conflict of interest statement

No direct conflicting relationship exists for any author. Dr. Patel is a consultant to Santen Inc., Design Therapeutics Inc., Iris Medicine Inc., Invirsa Inc., and Emmecell, had recent consulting activities with GlaxoSmithKline, and developed V-FUCHS, which Mayo Clinic licenses to Santen Inc., Design Therapeutics Inc, Iris Medicine Inc., and Kowa Research Institute. All relationships are unrelated to the topic of the manuscript. The abstract of this paper was presented at the 2022 Annual Meeting of the Association for Research in Vision and Ophthalmology as a poster presentation with interim findings. The poster’s abstract was published in Investigative Ophthalmology & Visual Science: https://iovs.arvojournals.org/article.aspx?articleid=2783087.31

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