A cross-sectional study on vision-related quality of life in patients with ocular GvHD

• Published in: Bone marrow transplantation (Basingstoke) Vol. 50; no. 9; pp. 1224 - 1226
• Main Authors: Pezzotta, S, Rossi, G C, Scudeller, L, Antoniazzi, E, Bianchi, P E, Perotti, C, Del Fante, C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2015; Nature Publishing Group
• Subjects: 692/308/174; 692/700/784; Allografts; Apheresis; Bone marrow; Bone marrow transplantation; Care and treatment; Cell Biology; Complications; Complications and side effects; Cornea; Cross-Sectional Studies; Female; Follow-Up Studies; Glaucoma - epidemiology; Glaucoma - etiology; Glaucoma - pathology; Glaucoma - physiopathology; Graft vs Host Disease - epidemiology; Graft vs Host Disease - etiology; Graft vs Host Disease - pathology; Graft vs Host Disease - physiopathology; Graft vs. host disease; Graft-versus-host reaction; Health aspects; Hematology; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Mental health; Middle Aged; original-article; Pain; Parameters; Patient outcomes; Photodynamic therapy; Public Health; Quality of Life; Risk factors; Signs and symptoms; Staining; Stem cell transplantation; Stem Cells; Transplantation; Vision; Visual perception; Italy
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2015.24

Ocular GvHD affects about 40–60% of patients receiving bone marrow transplantation. Ocular complaints worsen quality of life (QoL), which, besides survival time, is a primary end point in a patient's follow-up. The aim of our study was to assess the ocular surface status and vision-related QoL (VRQoL) and explore the potential determinants in VRQoL in patients with chronic GvHD with ocular involvement. In this cross-sectional study, we investigated 40 patients with ocular GvHD after allogeneic hematopoietic stem cell transplantation assessing ocular symptoms and signs, VRQoL and ophthalmologic parameters. The median age was 52.1 years; 32.5% were females. Most of them presented a multiple organ involvement. Ophthalmological parameter examinations were on average abnormal. Corneal staining was severe/very severe in 25%; conjunctival staining in 10% of subjects. The worse QoL scores were on ‘general vision’, ‘ocular pain’, ‘vision-specific mental health’ and ‘vision-specific role difficulties’. Both symptoms and sign scores indicate poor VRQoL. A lower VRQoL was related to schooling level, job position, underlying disease and extracorporeal photopheresis. Corneal staining, Schirmer and tear film breakup time were negatively associated to visual function-related subscales. An accurate ophthalmological and VRQoL assessment should be mandatory for a long time to promptly recognize early signs of ocular suffering, and to prevent irreversible ocular complications.