Citation:Aldebasi T,Bashir R,Gangadharan S,A N. Shaheen,Basil Alhussain,Tariq Almudhaiyan,Bader Alahmari.Incidence of ocular manifestations in patients with graft versus host disease after allogeneic stem cell transplant in Riyadh, Saudi Arabia.Int J Ophthalmol 2022;15(7):1149-1156,doi:10.18240/ijo.2022.07.16
Incidence of ocular manifestations in patients with graft versus host disease after allogeneic stem cell transplant in Riyadh, Saudi Arabia
Received:July 08, 2021  Revised:April 28, 2022
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DOI:10.18240/ijo.2022.07.16
Key Words:graft versus host disease  allogenic stem cell transplant  dry eye
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Tariq Aldebasi Department of Ophthalmology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Rabia Bashir Department of Ophthalmology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Shiji Gangadharan Department of Ophthalmology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Naila A. Shaheen King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Basil Alhussain Department of Ophthalmology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Tariq Almudhaiyan Department of Ophthalmology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia; King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
Bader Alahmari King Abdullah International Medical Research Center KAIMRC, Riyadh 11426, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia; Divisions of Adult Hematology and SCT, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia
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Abstract:
      AIM: To evaluate the incidence and severity of ocular graft versus host disease (oGVHD) in patients who underwent allogeneic stem cell transplant (SCT) in King Abdul-Aziz Medical City, Saudi Arabia.

    METHODS: This is a retrospective cohort study conducted in King Abdul Aziz Medical City on patients who underwent allogeneic hematopoietic cell transplant (allo-HCT) from 2010 to 2017. The ocular examination findings including visual acuity, meibomian gland dysfunction, corneal and conjunctival staining with severity, corneal scarring, tear film meniscus and breakup time, anterior and posterior segment examination findings, intraocular pressure, treatment given, punctual plugs used or not, and follow up response were collected.

    RESULTS: The five years cumulative incidence of oGVHD among post-transplant patients was 56.98% (95%CI 38.6%-71.7%). The potential risk factors assessed for developing ocular manifestation were age, gender, donor’s age, donor gender mismatch CD3 and CD34 infusion, while none of the correlates were identified as statistically significant risk factors of developing ocular manifestation. However, the incidence was statistically significantly different between patients diagnosed with acute myelocytic leukemia and acute lymphocytic leukemia (P=0.038). The mean latent period to develop ocular symptoms was 20.5mo. All patients had variable degree of dry eyes. None of the patients developed any posterior segment complication.

    CONCLUSION: The incidence of oGVHD is low in King Abdul-Aziz Medical City. This can be attributed to the preconditioning and immunosuppressive regime.

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