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Graft-Versus-Host Disease

  • Edgar M. Espana
  • Lauren Jeang
  • Arun D. Singh
Chapter

Abstract

Graft-versus-host disease (GVHD) is a serious and devastating complication following bone marrow transplantation. Acute or chronic systemic GVHD can be lethal, and severe damage of different organs and tissues occurs with both types of GVHD. Ocular involvement, either in an acute or chronic presentation, may range from mild to severe. Chronic ocular GVHD, the most common form of GVHD, affects mainly the ocular surface components: lacrimal gland, meibomian glands, cornea, and conjunctiva, mimicking other immunologically mediated inflammatory diseases of the ocular surface. The long-term treatment of ocular GVHD continues to be challenging and involves a multidisciplinary approach where medical and surgical options are necessary. Systemic immunosuppression, ocular lubricants, topical steroids, and topical cyclosporine are commonly prescribed. More aggressive therapeutic interventions for moderate and severe ocular GVHD include the use of serum eye drops and scleral contact lenses. In this chapter, we review the mechanisms, clinical findings, and treatment of ocular GVHD.

Keywords

GVHD Sicca Dry eyes Serum eye drops Scleral lenses Immunosuppression 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Edgar M. Espana
    • 1
  • Lauren Jeang
    • 2
  • Arun D. Singh
    • 3
  1. 1.Department of OphthalmologyUniversity of South FloridaTampaUSA
  2. 2.Department of OphthalmologyNew England Eye Center/Tufts Medical CenterBostonUSA
  3. 3.Department of Ophthalmic OncologyCole Eye Institute, Cleveland ClinicClevelandUSA

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