Current insights into ocular graft-versus-host disease

PURPOSE OF REVIEW: To update our knowledge on hematopoietic stem cell transplantation (SCT) and graft-versus-host disease (GVHD) and summarize the current treatment options for ocular GVHD.

RECENT FINDINGS: Allogeneic (allo)-SCT represents a treatment option for a number of hematological malignancies and bone marrow disorders; the indications for this procedure are still increasing. Ocular GVHD develops in 40-60% of patients after allo-SCT, can cause severe ocular surface disease and has a negative impact on quality of life. There are no widely accepted guidelines for the treatment of ocular GVHD. In addition to the usual treatment with artificial tears, topical steroids, punctal occlusion and contact lenses, recent treatment options include anti-inflammatory medications including topical cyclosporine A and tacrolimus. Unfortunately, none of the treatment regimens are completely satisfactory and systematic data on the efficacy of these agents are lacking. The preventive treatment possibilities for ocular GVHD have not been defined.

SUMMARY: This review summarizes current data on ocular GVHD and focuses on novel treatment options for this severe ocular disorder. More data on the impact of ocular GVHD and the development of therapeutic and preventive measures are needed.