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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
Ahmad Kheirkhah, Thomas Dohlman, Ujwala Saboo, Reza Dana
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA

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