Update on ocular graft-versus-host disease.
Update on ocular graft-versus-host disease.
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DOI：
10.4103/ijo.ijo_2016_20
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发表时间：
2021-05
影响因子：
3.1
通讯作者：
Ogawa Y
中科院分区：
文献类型：
--
作者：
Nair S;Vanathi M;Mukhija R;Tandon R;Jain S;Ogawa Y
眼移植物抗宿主病（oGVHD）是造血干细胞移植后的一种并发症，与显着的眼部发病率相关，导致生活质量显着下降。由于目前治疗方案尚未达成共识，治疗变得具有挑战性，因为复发性移植物抗宿主病通常对常规治疗无效。现在，大多数作者根据美国国立卫生研究院共识会议 (NIH CC) 或国际慢性 oGVHD (ICCGVHD) 共识小组提供的标准对该疾病进行诊断和分级。本文将深入介绍 oGVHD 的诊断标准、分类和临床严重程度分级量表。 oGVHD 的炎症过程可累及整个眼表，包括眼睑、睑板腺、角膜、结膜和泪道系统。本研究讨论了不同的临床表现和用于管理它们的治疗策略。 oGVHD 患者眼表成像的最新进展，例如使用眼睑造影和体内共聚焦显微镜，可能有助于该疾病的早期诊断和预测。研究 oGVHD 患者的泪液蛋白质组学和识别新型潜在泪液生物标志物是一个令人兴奋的领域，因为它们可能有助于客观诊断疾病和监测治疗反应。
Ocular graft-versus-host disease (oGVHD) occurs as a complication following hematopoietic stem cell transplantation and is associated with significant ocular morbidity resulting in a marked reduction in the quality of life. With no current consensus on treatment protocols, management becomes challenging as recurrent oGVHD often refractory to conventional treatment. Most authors now diagnose and grade the disease based on criteria provided by the National Institutes of Health Consensus Conference (NIH CC) or the International Chronic oGVHD (ICCGVHD) consensus group. This article will provide an insight into the diagnostic criteria of oGVHD, its classification, and clinical severity grading scales. The inflammatory process in oGVHD can involve the entire ocular surface including the eyelids, meibomian gland, corneal, conjunctiva, and lacrimal system. The varied clinical presentations and treatment strategies employed to manage them have been discussed in the present study. The recent advances in ocular surface imaging in oGVHD patients such as the use of meibography and in vivo confocal microscopy may help in early diagnosis and prognostication of the disease. Researching tear proteomics and identification of novel potential tear biomarkers in oGVHD patients is an exciting field as they may help in objectively diagnosing the disease and monitoring the response to treatment.