SCLERO-CORNEAL LENSES SAFE AND EFFICIENT FOR THE TREATMENT OF KERATOCONJUNCTIVITIS SICCA IN PATIENTS WITH REFRACTORY OCULAR GVHD: A STUDY ON BEHALF OF THE SFGM-TC.
(Abstract release date: 05/19/16)
EHA Library. Magro L. 06/09/16; 133052; E1503
Dr. Leonardo Magro
Contributions
Contributions
Abstract
Abstract: E1503
Type: Eposter Presentation
Background
Keratoconjunctivitis sicca syndrome (KCS) due to chronic GvHD (cGvHD) is responsible for major alteration in quality of life of patients undergoing allogeneic stem cell transplantation (allo-CST). The conjunctival fibrosis secondary to inflammation is often slow and subtle and is responsible for impaired corneal and conjunctival epithelial surfaces potentiated by tear quantitative and qualitative deficiency. Treatment of KCS remains disappointing; variable success in the correction of the conjunctival dryness has been obtained with variety of topical treatments with or without systemic immunosuppressive agents. These treatments, though, do not seem to have any effect on sicca symptoms and patients’ quality of life. Sclero-corneal lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity.
Aims
Scleral lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity. In this multicenter retrospective study we wanted to assess the incidence of scleral lenses on sixty one patients concerning by refractory ocular GVHD.
Methods
We describe the safety and efficacy of Sclero-corneal lenses in a retrospective analysis of 62 patients with KCS due to cGvHD following allo-CST. All patients had superficial punctate keratitis refractory to standard treatments. Evaluation of patients was carried out by two ophthalmologists. cGVHD was recorded according standard criteria. Ocular surface disease index (OSDI) and Oxford score were used to evaluate ocular symptoms. The scale of 'Monoyer' was used and converted into visual acuity 'LOG MAR' for comparative purposes of the study.
Results
All patients but two agreed to hold the lenses. The 62 patients were equipped with sclero-corneal lenses. With a median follow-up of 22 months (IQR 8-43) from the treatment with lenses, all patients have experienced an improvement in their quality of life with a clear improvement of dry-eye symptoms. This quality of life is also improved by decreasing the frequency of eye-drop instillation and the attenuation of the discomfort and post-instillation visual fluctuation. At two months, all patients but one experienced improvement in OSDI score with a median of 92 points (range, 40-100) before lenses to a median of 25 points (range, 3-90). We also observed improvement or stability of visual acuity with median gain of -0.2 (range, -1 to +0.1) LOG MAR acuity and improvement or stability of the Oxford score score with a median of 3 points (range, 0-5) before lenses to a median of 1 points (range, 0-4) after lenses. with a median gain of 2 points in almost all patients.
Conclusion
Treatment of KCS with sclero-corneal lenses is promising. Whenever possible, this approach should be considered in patients experiencing KCS due to cGVHD.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Graft-versus-host disease (GVHD), Quality of life, Salvage therapy
Type: Eposter Presentation
Background
Keratoconjunctivitis sicca syndrome (KCS) due to chronic GvHD (cGvHD) is responsible for major alteration in quality of life of patients undergoing allogeneic stem cell transplantation (allo-CST). The conjunctival fibrosis secondary to inflammation is often slow and subtle and is responsible for impaired corneal and conjunctival epithelial surfaces potentiated by tear quantitative and qualitative deficiency. Treatment of KCS remains disappointing; variable success in the correction of the conjunctival dryness has been obtained with variety of topical treatments with or without systemic immunosuppressive agents. These treatments, though, do not seem to have any effect on sicca symptoms and patients’ quality of life. Sclero-corneal lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity.
Aims
Scleral lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity. In this multicenter retrospective study we wanted to assess the incidence of scleral lenses on sixty one patients concerning by refractory ocular GVHD.
Methods
We describe the safety and efficacy of Sclero-corneal lenses in a retrospective analysis of 62 patients with KCS due to cGvHD following allo-CST. All patients had superficial punctate keratitis refractory to standard treatments. Evaluation of patients was carried out by two ophthalmologists. cGVHD was recorded according standard criteria. Ocular surface disease index (OSDI) and Oxford score were used to evaluate ocular symptoms. The scale of 'Monoyer' was used and converted into visual acuity 'LOG MAR' for comparative purposes of the study.
Results
All patients but two agreed to hold the lenses. The 62 patients were equipped with sclero-corneal lenses. With a median follow-up of 22 months (IQR 8-43) from the treatment with lenses, all patients have experienced an improvement in their quality of life with a clear improvement of dry-eye symptoms. This quality of life is also improved by decreasing the frequency of eye-drop instillation and the attenuation of the discomfort and post-instillation visual fluctuation. At two months, all patients but one experienced improvement in OSDI score with a median of 92 points (range, 40-100) before lenses to a median of 25 points (range, 3-90). We also observed improvement or stability of visual acuity with median gain of -0.2 (range, -1 to +0.1) LOG MAR acuity and improvement or stability of the Oxford score score with a median of 3 points (range, 0-5) before lenses to a median of 1 points (range, 0-4) after lenses. with a median gain of 2 points in almost all patients.
Conclusion
Treatment of KCS with sclero-corneal lenses is promising. Whenever possible, this approach should be considered in patients experiencing KCS due to cGVHD.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Graft-versus-host disease (GVHD), Quality of life, Salvage therapy
Abstract: E1503
Type: Eposter Presentation
Background
Keratoconjunctivitis sicca syndrome (KCS) due to chronic GvHD (cGvHD) is responsible for major alteration in quality of life of patients undergoing allogeneic stem cell transplantation (allo-CST). The conjunctival fibrosis secondary to inflammation is often slow and subtle and is responsible for impaired corneal and conjunctival epithelial surfaces potentiated by tear quantitative and qualitative deficiency. Treatment of KCS remains disappointing; variable success in the correction of the conjunctival dryness has been obtained with variety of topical treatments with or without systemic immunosuppressive agents. These treatments, though, do not seem to have any effect on sicca symptoms and patients’ quality of life. Sclero-corneal lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity.
Aims
Scleral lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity. In this multicenter retrospective study we wanted to assess the incidence of scleral lenses on sixty one patients concerning by refractory ocular GVHD.
Methods
We describe the safety and efficacy of Sclero-corneal lenses in a retrospective analysis of 62 patients with KCS due to cGvHD following allo-CST. All patients had superficial punctate keratitis refractory to standard treatments. Evaluation of patients was carried out by two ophthalmologists. cGVHD was recorded according standard criteria. Ocular surface disease index (OSDI) and Oxford score were used to evaluate ocular symptoms. The scale of 'Monoyer' was used and converted into visual acuity 'LOG MAR' for comparative purposes of the study.
Results
All patients but two agreed to hold the lenses. The 62 patients were equipped with sclero-corneal lenses. With a median follow-up of 22 months (IQR 8-43) from the treatment with lenses, all patients have experienced an improvement in their quality of life with a clear improvement of dry-eye symptoms. This quality of life is also improved by decreasing the frequency of eye-drop instillation and the attenuation of the discomfort and post-instillation visual fluctuation. At two months, all patients but one experienced improvement in OSDI score with a median of 92 points (range, 40-100) before lenses to a median of 25 points (range, 3-90). We also observed improvement or stability of visual acuity with median gain of -0.2 (range, -1 to +0.1) LOG MAR acuity and improvement or stability of the Oxford score score with a median of 3 points (range, 0-5) before lenses to a median of 1 points (range, 0-4) after lenses. with a median gain of 2 points in almost all patients.
Conclusion
Treatment of KCS with sclero-corneal lenses is promising. Whenever possible, this approach should be considered in patients experiencing KCS due to cGVHD.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Graft-versus-host disease (GVHD), Quality of life, Salvage therapy
Type: Eposter Presentation
Background
Keratoconjunctivitis sicca syndrome (KCS) due to chronic GvHD (cGvHD) is responsible for major alteration in quality of life of patients undergoing allogeneic stem cell transplantation (allo-CST). The conjunctival fibrosis secondary to inflammation is often slow and subtle and is responsible for impaired corneal and conjunctival epithelial surfaces potentiated by tear quantitative and qualitative deficiency. Treatment of KCS remains disappointing; variable success in the correction of the conjunctival dryness has been obtained with variety of topical treatments with or without systemic immunosuppressive agents. These treatments, though, do not seem to have any effect on sicca symptoms and patients’ quality of life. Sclero-corneal lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity.
Aims
Scleral lenses bring a valid therapeutic option by creating a pre-corneal reservoir of tears allowing permanent lubrication of the epithelium, the protection of the corneal surface against the eyelid and ciliary mechanical friction and against environmental stresses and the creation of a uniform refractive surface to be taken into optimum optical load and stable visual acuity. In this multicenter retrospective study we wanted to assess the incidence of scleral lenses on sixty one patients concerning by refractory ocular GVHD.
Methods
We describe the safety and efficacy of Sclero-corneal lenses in a retrospective analysis of 62 patients with KCS due to cGvHD following allo-CST. All patients had superficial punctate keratitis refractory to standard treatments. Evaluation of patients was carried out by two ophthalmologists. cGVHD was recorded according standard criteria. Ocular surface disease index (OSDI) and Oxford score were used to evaluate ocular symptoms. The scale of 'Monoyer' was used and converted into visual acuity 'LOG MAR' for comparative purposes of the study.
Results
All patients but two agreed to hold the lenses. The 62 patients were equipped with sclero-corneal lenses. With a median follow-up of 22 months (IQR 8-43) from the treatment with lenses, all patients have experienced an improvement in their quality of life with a clear improvement of dry-eye symptoms. This quality of life is also improved by decreasing the frequency of eye-drop instillation and the attenuation of the discomfort and post-instillation visual fluctuation. At two months, all patients but one experienced improvement in OSDI score with a median of 92 points (range, 40-100) before lenses to a median of 25 points (range, 3-90). We also observed improvement or stability of visual acuity with median gain of -0.2 (range, -1 to +0.1) LOG MAR acuity and improvement or stability of the Oxford score score with a median of 3 points (range, 0-5) before lenses to a median of 1 points (range, 0-4) after lenses. with a median gain of 2 points in almost all patients.
Conclusion
Treatment of KCS with sclero-corneal lenses is promising. Whenever possible, this approach should be considered in patients experiencing KCS due to cGVHD.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Graft-versus-host disease (GVHD), Quality of life, Salvage therapy
{{ help_message }}
{{filter}}