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Ophthalmic Findings in Graft Versus Host Disease

Ophthalmic Findings in Graft Versus Host Disease. Sutton Eye Unit Epsom & St Helier University Hospitals NHS Trust Dr William R Tucker Dr Saruban Pasu Miss Andrena McElvanney. The authors have no financial interest in the subject matter or products described in this presentation. Purpose.

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Ophthalmic Findings in Graft Versus Host Disease

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  1. Ophthalmic Findings in Graft Versus Host Disease Sutton Eye Unit Epsom & St Helier University Hospitals NHS Trust Dr William R Tucker Dr Saruban Pasu Miss Andrena McElvanney The authors have no financial interest in the subject matter or products described in this presentation

  2. Purpose • To describe the clinical findings in a series of 8 patients with Graft versus Host Disease (GvHD) • The patients had previously received allogenic bone marrow transplant (BMT) for haematological malignancy

  3. Methods • All 8 patients presented to Sutton Eye Unit (UK) from the adjoining Royal Marsden Hospital • The Royal Marsden was the world’s first dedicated cancer hospital and is still a worldwide leader in cancer care

  4. Methods • Patients presented between 2005 – 2009 • Referred with a presumed diagnosis of ocular GvHD • Clinical history and examination was recorded with at least 6 months followup data collected (range 6 months to 2 years)

  5. Results - Demographics • Male:Female ratio was 1:1 • The average age at diagnosis was 32 (range 22 – 44) • The underlying diseases were Acute Myeloid Leukaemia (5 patients) and Acute Lymphoblastic Leukaemia (3 patients) • Average time to presentation following BMT was 120 days (range 14 – 360 days) • 4 patients were considered to have acute GvHD having presented within 2 months

  6. Results – Clinical Findings • Punctate epitheliopathy present in all patients and in 4 was considered severe with development of filaments • Meibomian gland blockage and posterior belpharitis were present in 100% of patients • Average Schirmer’s test result at 5 minutes was 5mm (range 1 to 12mm)

  7. Results – Treatment Disease Severity At most recent follow-up the treatment regimen as detailed above had produced improved clinical signs and resolution of symptoms in all patients

  8. Conclusion • Ocular GvHD can adversely affect the quality of life of many patients following BMT • All of our cases demonstrated uncomfortable dry eyes with marked posterior blepharitis • Our initial treatment regimen was well tolerated • In our opinion specific treatment for posterior blepharitis – in this case lid hygiene and Fusidic Acid 1% gel twice a day – helped with the clinical improvement of the overall picture

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