A Review of Ocular Graft-versus-Host Disease: Pathophysiology, Clinical Presentation and Management

Ocul Immunol Inflamm. 2021 Aug 18;29(6):1190-1199. doi: 10.1080/09273948.2021.1939390. Epub 2021 Jul 6.

Abstract

Graft-versus-host disease is a common complication following allogeneic hematopoetic stem cell transplantation that can affect multiple organ systems, including the eyes. Ocular GVHD (oGVHD) is characterized by a T cell-mediated immune response that leads to immune cell infiltration and inflammation of ocular structures, including the lacrimal glands, eyelids, cornea and conjunctiva. oGVHD has a significant negative impact on visual function and quality of life and successful management requires a multi-disciplinary approach with frequent monitoring. Here, we review the pathophysiology and clinical presentation of oGVHD, along with current therapeutic strategies based on our clinical experience and the reported literature.

Keywords: Allogeneic hematopoietic stem cell transplantation; T cells; dry eye disease; graft-versus-host disease; ocular graft-versus-host disease; ocular surface disease.

Publication types

  • Review

MeSH terms

  • Dry Eye Syndromes / physiopathology
  • Eye Diseases* / diagnosis
  • Eye Diseases* / physiopathology
  • Eye Diseases* / therapy
  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / physiopathology
  • Graft vs Host Disease* / therapy
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Quality of Life
  • T-Lymphocytes / immunology