Long-term clinical outcomes in ocular cGvHD: A 5-year study

Results from a retrospective, single-center study evaluating outcomes and treatment trajectories in patients with ocular chronic graft-versus-host disease (ocular cGvHD; N = 189) were published in Eye by Gill et al. The study included patients with ≥1 year of follow-up after diagnosis and aimed to characterize longitudinal ocular outcomes, therapeutic burden, and correlations with National Institutes of Health (NIH) Eye, Lung, and Mouth Scores over 5 years.

Key data: At final follow-up, meibomian gland dysfunction (MGD) and superficial punctate keratitis (SPK) persisted in 56.1% and 55.6% of patients, respectively; a subset of patients also developed vision-threatening sequelae, including filamentary keratitis (3.7%), corneal neovascularization (2.6%), and limbal stem cell deficiency (LSCD; 4.8%). Therapeutic escalation was common, and included artificial tears (92.1%), autologous serum tears (47.1%), punctal cautery (28.0%), scleral lenses (19.0%), and topical cyclosporine (7.4%). Higher baseline NIH Eye Scores were associated with an increased incidence of filamentary keratitis (Spearman’s ρ = 0.371) and adjunctive treatments (Spearman’s ρ = 0.186); higher baseline NIH Lung Scores with filamentary keratitis (Spearman’s ρ = 0.300); and higher baseline NIH Mouth Scores with SPK incidence (Spearman’s ρ = 0.212) and corneal thinning (Spearman’s ρ = 0.212), with all associations statistically significant (all unadjusted p < 0.05).

Key learning: These findings over a 5-year follow-up period highlight the progressive nature of ocular cGvHD, with persistent ocular complications and escalating treatment needs over time. NIH-based risk stratification and multidisciplinary management may help preserve vision and quality of life (QoL) in affected patients.