Skip Navigation LinksHome > December 2010 - Volume 29 - Issue 12 > Treatment of Ocular Graft-Versus-Host Disease With Topical C...
doi: 10.1097/ICO.0b013e3181e456f0
Clinical Science

Treatment of Ocular Graft-Versus-Host Disease With Topical Cyclosporine 0.05%

Malta, João Baptista MD*†; Soong, H Kaz MD*; Shtein, Roni M MD*; Musch, David C PhD, MPH*‡; Rhoades, William BS*; Sugar, Alan MD*; Mian, Shahzad I MD*

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Purpose: To evaluate the efficacy of topical cyclosporine-A 0.05% (CsA) in the treatment of dry eye syndrome in ocular graft-versus-host disease after bone marrow transplantation (BMT) of hematopoietic stem cells.

Methods: One-hundred five patients were enrolled in a retrospective, comparative, interventional case series. Eighty-one patients received topical CsA starting 1 month before BMT (treatment group), and 24 patients did not receive CsA until at least 6 months after the transplantation (control group). Mean follow-up time was 17.5 ± 11.0 months (range: 6.0-49.0 months). Clinical history, ocular surface disease index questionnaire, slit-lamp examination, lissamine green and fluorescein staining of the ocular surface, tear breakup time, and Schirmer test with topical anesthesia were obtained to create a composite dry eye-grading score.

Results: Dry eye symptoms were significantly more severe in the control group at 3 months, 1 year, and 2 years (P < 0.05). There was no correlation with type of stem cell transplant (related vs. unrelated donor), presenting indication for BMT, or concurrent systemic immunosuppressive medications.

Conclusions: Pre-BMT initiation of topical CsA may reduce the inflammatory response in the lacrimal glands that may be responsible for the development of post-BMT keratitis sicca.

© 2010 Lippincott Williams & Wilkins, Inc.


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