Amniotic membrane effective in GVHD-induced dry eye disease
In patients with dry eye disease caused by ocular graft-vs.-host disease, Marta Ponce Contreras, MD, and colleagues found cryopreserved amniotic membrane treatment improved ocular signs and symptoms in patients whose disease was refractory to conventional therapy.
Corneal manifestations of ocular GVHD disease can be severe, leading to corneal erosion, thinning, ulceration and perforation. Early identification and treatment, with regular follow-up visits are important to prevent progression, the authors said in a poster presented at the virtual American Society of Cataract and Refractive Surgery meeting.
To evaluate the efficacy of self-retained cryopreserved amniotic membrane (Prokera Slim, Bio-Tissue) as treatment for GVHD-induced dry eye disease refractory to conventional therapy, Contreras and colleagues studied 26 eyes of 14 consecutive patients in a retrospective chart review. All eyes demonstrated discomfort, dryness, redness, photophobia, tear film abnormalities and ocular surface damage. Artificial tears and punctal plugs were tried in all eyes; additionally, 42% of eyes were previously treated with Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan), 19% with serum drops and 12% with Xiidra (lifitegrast ophthalmic solution 5%, Novartis).
After treatment with cryopreserved amniotic membrane, all patients had improved symptoms of foreign body sensation, photophobia and ability to perform daily tasks. Objective improvements included decreased corneal staining in 26 eyes, improvement of filamentary keratopathy in nine eyes and decreased NIH ocular GVHD score in 11 eyes.
- Contreras MP, et al. Management of GVHD-induced dry-eye disease with self-retaining cryopreserved amniotic membrane. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 16-17, 2020 (virtual meeting).