Читать книгу Blood and Marrow Transplantation Long Term Management - Группа авторов - Страница 90

Ocular cGVHD commonly results in decreased lacrimal gland function, resulting in chronic dry eye (keratoconjunctivitis sicca) as the main late effect and its incidence may be up to 40% among patients with cGVHD [76]. Tear production can be measured with the Schirmer test but since this may be technically challenging to transplant clinicians, it is no longer an absolute requirement for organ severity scores of cGVHD as per the 2014 NIH cGVHD criteria. Non‐cGVHD ocular complications include cataracts, ischemic retinopathy, and infections. Cumulative incidence of cataracts in children has been reported to be 36% at 15 years post‐HCT [38]. Though TBI has a strong association with cataracts, many patients remain at risk for cataract due to chronic corticosteroid therapy for cGVHD. Ischemic retinopathy is an uncommon complication but has been described in HCT settings, particularly in the setting of systemic cyclosporine use.

Since complete vision loss impairs QoL of long‐term HCT survivors more than any other organ complication, HCT recipients must have ophthalmologic examinations at regular intervals. Detailed management of ocular complications is given in Chapter 16.