Keratoconjunctivitis Sicca in Graft-Versus-Host Disease
- Common after bone marrow transplantation.
- Some ocular manifestation such as keratoconjunctivitis sicca (KCS), sterile conjunctivitis, cicatricial lagophthalmos, cataracts and retinal microvascular occlusive disease have commonly observed in patients with GVHD.
- KCS is the most significant ocular complication associated with acute and chronic GVHD.
- Foreign body sensation, itching, burning, and moderate conjunctival redness
- Decreased vision, pain, and photophobia usually occur in advanced cases
- Exacerbated by wind, blinking, or prolonged reading.
- Minimal or absent tear meniscus
- Mucus threads and conjunctival hyperemia
- Fine, medium or coarse epithelial keratitis
- Filamentary keratitis may be found especially in the interpalperal fissure
- Epithelial erosion, subsequent stromal ulceration and recurrent corneal infections may occur in more severe cases.
- Complications include corneal scarring, neovascularization, or conjunctivalization of the cornea.
- Vigorous surface lubrication with artificial non-preservativeartificial tears or ointment.
- Treatment of associated systemic diseases.
- Punctal occlusion.
- Humidifiers or moisture chambers to decrease tear film evaporation.
- Surgical tarsorraphy for intractable dry eye.