TY - JOUR
T1 - The Eye in Bone Marrow Transplantation
T2 - III. Conjunctival Graft-vs-Host Disease
AU - Jabs, Douglas A.
AU - Wingard, John
AU - Green, W. Richard
AU - Farmer, Evan R.
AU - Vogelsang, Georgia
AU - Saral, Rein
PY - 1989/9
Y1 - 1989/9
N2 - Of a series of 263 patients undergoing allogeneic bone marrow transplantation (BMT), 24 patients developed conjunctival involvement by graft-vs-host disease (GVHD). In each case, a distinctappearing conjunctivitis developed that represented GVHD of the conjunctiva. In 19 cases (79%), conjunctival GVHD presented with pseudomembrane formation due to loss of the conjunctival epithelium; in 4 of these cases, the corneal epithelium was lost as well. Nineteen patients developed this feature in association with acute GVHD, and mortality among these patients was 89.5%. Kaplan-Meier analysis of survival demonstrated a decreased survival of patients with conjunctival involvement compared with all marrow transplant recipients and compared with all patients with GVHD. However, survival was similar to that seen in patients with severe systemic GVHD (overall stages II through IV). Five patients developed conjunctival GVHD in association with chronic GVHD, and all had severe chronic GVHD. Four of these five with chronic GVHD subsequently died. Conjunctival involvement by GVHD represents a distinct clinical finding and is a marker for severe systemic involvement by GVHD. A clinical staging system for ocular involvement was formulated.
AB - Of a series of 263 patients undergoing allogeneic bone marrow transplantation (BMT), 24 patients developed conjunctival involvement by graft-vs-host disease (GVHD). In each case, a distinctappearing conjunctivitis developed that represented GVHD of the conjunctiva. In 19 cases (79%), conjunctival GVHD presented with pseudomembrane formation due to loss of the conjunctival epithelium; in 4 of these cases, the corneal epithelium was lost as well. Nineteen patients developed this feature in association with acute GVHD, and mortality among these patients was 89.5%. Kaplan-Meier analysis of survival demonstrated a decreased survival of patients with conjunctival involvement compared with all marrow transplant recipients and compared with all patients with GVHD. However, survival was similar to that seen in patients with severe systemic GVHD (overall stages II through IV). Five patients developed conjunctival GVHD in association with chronic GVHD, and all had severe chronic GVHD. Four of these five with chronic GVHD subsequently died. Conjunctival involvement by GVHD represents a distinct clinical finding and is a marker for severe systemic involvement by GVHD. A clinical staging system for ocular involvement was formulated.
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U2 - 10.1001/archopht.1989.01070020413046
DO - 10.1001/archopht.1989.01070020413046
M3 - Article
C2 - 2675805
AN - SCOPUS:0024431755
SN - 0003-9950
VL - 107
SP - 1343
EP - 1348
JO - Archives of ophthalmology
JF - Archives of ophthalmology
IS - 9
ER -