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2015 Agenda and Abstracts | < Previous 2015 OMIG Abstract 28 Reduced Efficacy of Low-dose Topical Steroids in Dry Eye Disease Associated with Ocular GVHD Purpose: To determine whether the response of dry eye disease (DED) to low-dose topical steroids is similar between patients with and without ocular graft-versus-host-disease (GVHD). Methods: This study included patients with moderate to severe DED with and without associated ocular GVHD. All cases had an Ocular Surface Disease Index (OSDI) score >22 and corneal fluorescein staining of 4 or more (National Eye Institute grading scale, 0-15). Both GVHD and non-GVHD groups received either a topical steroid (loteprednol etabonate 0.5%) or artificial tear (AT) twice daily for 4 weeks. Clinical signs and symptoms were compared among the subgroups before and after the treatment. Results: 42 patients with DED completed the 4-week follow-up. These included 21 patients with ocular GVHD (including 9 on AT and 12 on steroid) and 21 patients without ocular GVHD (including 11 on AT and 10 on steroid). There were no significant differences among the subgroups at baseline. After 4 weeks of treatment in the non-GVHD group, corneal fluorescein staining decreased significantly in both the AT and steroid treated subgroups (29.8 ± 34.8% and 41.2 ± 36.5%, respectively); however, a significant improvement of OSDI was noticed only in the steroid group (35.1±14.4% reduction). In the GVHD group, there was no significant improvement in OSDI or any clinical signs after treatment with either AT or steroids. Conclusions: Even with similar clinical severity of DED, patients with ocular GVHD have a less favorable response to low-dose topical steroid therapy compared to those without ocular GVHD. These data suggest that a more aggressive therapy may be recommended in these cases. Funding: Bausch & Lomb, Inc. Financial Disclosure: AK (N), TD (N), US (N), RD (N). 2015 Agenda and Abstracts | < Previous
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