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Ocular Graft-versus-Host Disease Underdiagnosis: A Survey Study
Journal article   Open access   Peer reviewed

Ocular Graft-versus-Host Disease Underdiagnosis: A Survey Study

Bradley A Colarusso, Shannon M Bligdon, Allen Y Ganjei, Alan Kwok, Daniel Brocks, Zhonghui K Luo and Alan T Murray
Clinical ophthalmology (Auckland, N.Z.), v 16, pp 1419-1426
2022
PMID: 35535126
url
https://www.dovepress.com/getfile.php?fileID=80501View
Published, Version of Record (VoR) Open
url
https://doi.org/10.2147/OPTH.S359539View
Published, Version of Record (VoR) Open

Abstract

hematopoietic stem cell transplantation cGVHD dry eye keratoconjunctivitis sicca oGVHD
To understand the degree and explore the possible causes of ocular graft-versus-host disease (oGVHD) underdiagnosis in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). A 15-question survey was emailed to 6032 subscribers to the Blood and Marrow Transplant Information Network. A total of 371 respondents confirmed the history of allo-HSCT, of which 335 were symptomatic. Their self-reported symptoms, onset, treatments tried, degree of symptom control and established diagnoses of systemic chronic graft-versus-host disease (cGVHD) and oGVHD were analyzed. Among the 335 symptomatic survey respondents, 306 reported their ocular symptom onset was after allo-HSCT, with only 170 [55.6% (170/306)] ever receiving a diagnosis of oGVHD; 23 reported worsening pre-existing ocular symptoms after allo-HSCT, with only 5 [21.7% (5/23)] ever receiving a diagnosis of oGVHD; 6 reported stable symptoms before and after allo-HSCT, with 1 ever receiving a diagnosis of oGVHD. Of the 176 respondents carrying the diagnosis of oGVHD, 167 [94.9% (167/176)] also had the diagnosis of cGVHD. Logistic regression analysis showed that the diagnosis of oGVHD was highly correlated with the number of symptoms and treatments one reported. Furthermore, 35% of the respondents with new onset ocular symptoms reported onset within the first 6 months after allo-HSCT (previously reported), as well as 39% of the respondents with worsened existing symptoms. oGVHD underdiagnosis is likely associated with the previous diagnostic criteria, in which cGVHD of another organ system was required. The correct notion that oGVHD commonly causes severe dry eye disease has likely led to its underdiagnosis in patients with fewer number of symptoms and/or who tried fewer treatments.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Ophthalmology
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